Spinal cord gliomas and hydrocephalus: utility of neuroendoscopy.
OBJECTIVE
The aim of this study is to report on the role of neuroendoscopy during the management of hydrocephalus that led to the diagnosis of intracranial tumoral dissemination and the subsequent finding of a spinal cord glioma.


RESULTS
We present two children each with an intramedullary astrocytoma that presented initially with hydrocephalus without spinal cord symptoms. In both cases leptomeningeal gliomatous dissemination was asserted during routine endoscopy for the management of hydrocephalus. The diagnosis of a cervical and a lower thoracic intramedullary tumor was made soon after on magnetic resonance imaging.


CONCLUSIONS
Spinal cord MRI with contrast should be considered initially in selected cases of hydrocephalus without evident diagnosis. The intraoperative diagnosis of gliomatous dissemination and secondary hydrocephalus due to unrecognized spinal cord gliomas was possible, in our experience, with the routine use of the neuroendoscope.
Galarza
M
M
Division of Neurosurgery, Children Hospital of Turin, Turin, Italy. galarza.marcelo@gmail.com
Peretta
P
P
Gazzeri
R
R
Cinalli
G
G
Forni
M
M
Morra
I
I
Ragazzi
P
P
Sandri
S
S
D001254:Astrocytoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002675:Child, Preschool; D003399:Craniotomy; D004724:Endoscopy; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D007223:Infant; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008578:Meninges / Q000473:pathology; D009361:Neoplasm Invasiveness / Q000473:pathology; D011149:Pons / Q000473:pathology; D013116:Spinal Cord / Q000473:pathology / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D020542:Third Ventricle / Q000473:pathology; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt; D014696:Ventriculostomy