Continuous Minor Bleeding from Tumor Surface in Patients with Craniopharyngiomas: Case Series of Nonobstructive Hydrocephalus

Abstract

Nonobstructive hydrocephalus in patients with craniopharyngiomas is uncommon. We describe our surgical series of 25 consecutive patients with craniopharyngioma who presented with hydrocephalus. Obstructive hydrocephalus was evident in most cases, and nonobstructive hydrocephalus was revealed in three cases. Even after improvement of cerebrospinal fluid (CSF) pathway obstruction by tumor removal, 10 patients (40%) required CSF diversion. Preoperative imaging study revealed thin intraventricular hemorrhage or superficial siderosis in five cases, and CSF examination revealed hemosiderin-laden phagocytes in one case. These findings indicate continuous bleeding into the CSF that might be associated with CSF malabsorption. We also describe a representative case of craniopharyngioma associated with nonobstructive hydrocephalus due to continuous minor bleeding from the tumor surface in a 62-year-old man with a complaint of disorientation and a decline in daily living activity.

Our study demonstrated that minor bleeding into the CSF is a possible mechanism of the development of nonobstructive hydrocephalus in patients with craniopharyngiomas.

Keywords

neuroendoscopy - craniopharyngioma - nonobstructive hydrocephalus - superficial siderosis

Ethical Approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from the patient.

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