ABSTRACT
A 54-year-old woman had a permanent catheter placed connecting the cavity of an inoperable recurrent cystic craniopharyngioma and an extracranial reservoir for easy decompression by aspiration. The cyst refilled so frequently that radiation was given to the cystic tumour. Almost four years after radiation treatment, the patient has been well and no aspirations have been required. The cyst "dried out" and a year after radiation injection of isotope through the reservoir showed that the intracranial end of the catheter was now lodging in ventricular or cisternal space.
Subject(s)
Craniopharyngioma/therapy , Neoplasm Recurrence, Local/therapy , Pituitary Neoplasms/therapy , Cerebrospinal Fluid Shunts , Combined Modality Therapy , Drainage , Female , Follow-Up Studies , Humans , Middle Aged , Pituitary IrradiationABSTRACT
Communicating hydrocephalus secondary to cerebral venous outflow obstruction has been reported in a few patients several months following removal of a TPN catheter. We report the case of an infant who developed this sequal 4 mo after the catheter was removed. We illustrate the techniques used to delineate the type of hydrocephalus. A lumbo-peritoneal shunt was performed to alleviate the condition.
Subject(s)
Hydrocephalus/etiology , Parenteral Nutrition, Total/adverse effects , Parenteral Nutrition/adverse effects , Cerebrospinal Fluid Shunts , Diarrhea, Infantile/therapy , Humans , Hydrocephalus/diagnostic imaging , Hydrocephalus/surgery , Infant , Lumbosacral Region , Male , Peritoneal Cavity , Tomography, X-Ray ComputedABSTRACT
An infant with chronic diarrhea developed hydrocephalus following treatment with total parenteral nutrition (TPN) via jugular vein catheterization. Total parenteral nutrition is used when nutritional needs cannot be met adequately by oral alimentation. Serial computerized tomograms showed progression of communicating hydrocephalus. Superior sagittal sinograms demonstrated bilateral internal jugular vein occlusion with extensive venous collateralization. Lumboperitoneal shunt effectively decreased raised CSF pressure. A judicious approach to alternative venous routes for hyperalimentation is suggested. Radiographic delineation of communicating hydrocephalus by computerized tomography and superior sagittal sinography is presented.
