Pseudotumor cerebri comorbid with meningioma: A review and case series

Concomitant Idiopathic Intracranial Hypertension, Normal Pressure Hydrocephalus, and Pleomorphic Xanthoastrocytoma: A Case Report and Review of the Literature

Background

Idiopathic intracranial hypertension (IIH) and normal pressure hydrocephalus (NPH) are disorders of the cerebrospinal fluid (CSF) flow dynamics. Pleomorphic xanthoastrocytoma (PXA) is a rare low-grade astrocytoma (World Health Organization grade II) representing <1% of astrocytomas. Combination of IIH and NPH with PXA is unheard of, with few published cases discussing the association of CNS tumors with either IIH or NPH, but never combined. We present a case of a 51-year-old woman with such a rare combination. Case Presentation. A fifty-one-year-old obese female presented with a progressive visual loss, abducens nerve palsy, and headache for three months. Further investigations revealed a right frontal tumor and ventriculomegaly on magnetic resonance imaging. Her symptoms improved remarkably after total surgical excision of the tumor with a ventriculoperitoneal (VP) shunt.

Conclusion

The pathophysiology behind NPH and IIH is still not fully understood, yet their management is mostly dependent on CSF diversion. The concomitant development of two different CSF dynamic diseases with a PXA has not been reported in the literature. We hypothesize that PXA may have sparked an abnormal CSF circulation pattern and ventriculomegaly.

Superior Sagittal Sinus: A Review of the History, Surgical Considerations, and Pathology

A systematic PubMed and Google Scholar search for studies related to the anatomy, history, surgical approaches, complications, and diseases of the superior sagittal sinus was performed. The purpose of this review is to elucidate some of the more recent advances of our understanding of this structure. One of the earliest anatomical landmarks to be described, the superior sagittal sinus (SSS, sinus sagittalis superior (Latin); "sagittalis" Latin for 'arrow' and "sinus" Latin for 'recess, bend, or bay') has been defined and redefined by the likes of Vesalius and Cushing. A review of the various methods of approaching pathology of the SSS is discussed, as well as the historical discovery of these methods. Disease states that were emphasized include invasion of the SSS by meningioma, as well as thrombosis and vascular malformations.