Intracranial hypertension as an initial manifestation of spinal neuroectodermal tumor.
A 19-year-old girl had headaches, blurred vision and vomiting for 2 weeks. Neurological examination revealed only bilateral papilloedema and left abducens palsy. Neuroimaging of the brain was normal. Cerebrospinal fluid study showed intracranial hypertension (IH), hypoglycorrhachia, hyperproteinorrhachia, and a negative cytology study. Eight months after the onset, paraparesis occurred. Spinal magnetic resonance imaging showed intramedullary masses at the cervical and thoracic cords with extensive seeding. Biopsy of the mass showed primitive neuroectodermal tumor (PNET). IH rarely occurs in patients with spinal cord neoplasms. Its incidence is low and the condition is always associated with signs of myelopathy. We report a patient whose initial manifestation of spinal PNET was IH only. Spinal tumor should be considered in IH patients whose intracranial examinations are negative.
Chen
Yi-Chun
YC
Department of Neurology, Chang Gung Memorial Hospital, 199 Tung Hwa North Road, 10591 Taipei, Taiwan.
Tang
Lok-Ming
LM
Chen
Chi-Jen
CJ
Jung
Shih-Ming
SM
Chen
Sien-Tsong
ST
D000328:Adult; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D018242:Neuroectodermal Tumors, Primitive / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D013904:Thoracic Vertebrae