Reversal of increased intracranial pressure with removal of a torcular epidermoid: case report.
| Autor: | Lam CH; Department of Neurosurgery, University of Minnesota, Minneapolis 55455, USA., Solomon RK, Clark HB, Casey SO |
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| Jazyk: | angličtina |
| Zdroj: | Neurosurgery [Neurosurgery] 2001 Apr; Vol. 48 (4), pp. 929-32. |
| DOI: | 10.1097/00006123-200104000-00049 |
| Abstrakt: | 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. |
| Databáze: | MEDLINE |
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