Diurnally fluctuating frontal dysequilibrium secondary to a pineal pilocytic astrocytoma: is this symptom associated with a check-valve mechanism in a pineal region tumor?
BACKGROUND
The clinical manifestations of obstructive hydrocephalus vary with the age of the patient, duration of the condition, and etiology of the hydrocephalus.


METHODS
A 14-year-old boy presented with diurnally fluctuating dysarthria, dysequilibrium of the gait, and retropulsion, probably due to transient obstruction by a tumor at the entrance of the cerebral aqueduct of the pineal region. This fluctuation was ascertained clinically by assessing the ICARS score 5 h after the patient was in the supine and erect positions.


CONCLUSIONS
This result suggests that the symptoms of hydrocephalus are possibly associated with a check-valve mechanism of the pineal tumor and may be related to transient compression of the basal ganglia and frontal lobes.
Kim
Tae-Won
TW
Department of Neurology, The Catholic University of Korea, Seoul, Korea.
Lee
Tae-Kyu
TK
Kim
Bum-Soo
BS
Lee
Kwang-Soo
KS
Song
In-Uk
IU
Kim
Joong-Seok
JS
D000293:Adolescent; D001254:Astrocytoma / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D002555:Cerebrospinal Fluid; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010870:Pineal Gland / Q000473:pathology*; D010871:Pinealoma / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D015173:Supratentorial Neoplasms / Q000150:complications* / Q000473:pathology / Q000503:physiopathology