Reversal of increased intracranial pressure with removal of a torcular epidermoid: case report.
Neurosurgery
; 48(4): 929-32, 2001 Apr.
Article
em En
| MEDLINE
| ID: mdl-11322454
ABSTRACT
OBJECTIVE AND IMPORTANCE Venous obstruction has been postulated as a cause of increased intracranial pressure, but it has been documented rarely. We present a case of obstruction of the torcula by a slow-growing epidermoid. The tumor caused increased intracranial pressure, which was relieved when it was excised. In addition, the torcular epidermoid is associated with a bifid straight sinus. CLINICAL PRESENTATION A 35-year-old man presented with a headache and a lump on the back of the head. Physical examination revealed a firm, bony lesion approximately 4 x 4 cm in size. Lumbar puncture demonstrated an intraspinal pressure of 39 cm H2O. Neuroradiological studies revealed an epidermoid that compressed and almost completely occluded the torcula. INTERVENTION After the tumor was resected, the intraspinal pressure decreased to 19 cm H2O and remained stable 6 months later. CONCLUSION:
Pure venous obstruction causes increased intracranial pressure. Removal of the obstruction relieves the intracranial hypertension. In addition, computed tomographic venography is a safe and easy method of documenting torcular anatomy, and it was useful in the follow-up of this patient. Computed tomographic venography can demonstrate a double straight sinus, which is a congenital variant that may be associated with the epidermoid.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hipertensão Intracraniana
/
Cisto Epidérmico
/
Osso Occipital
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Neurosurgery
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
Estados Unidos