Tumor-Associated Non-Communicating Hydrocephalus

What Is It?

Tumor-associated non-communicating hydrocephalus is a form of obstructive hydrocephalus which is caused by a brain tumor. In general, the normal dynamics of cerebrospinal fluid in the brain requires free flow of the water-like fluid through the ventricles of the brain. Blockage of this fluid flow can lead to hydrocephalus.

A tumor in the brain which occurs within or near the ventricles can block this normal flow of cerebrospinal fluid if it grows large enough to fully obstruct these fluid-filled chambers. One of the most common sites for this type of obstruction is at the cerebral aqueduct. This narrow channel is normally small so a tumor in the area need not be very large to cause aqueductal stenosis and blockage of fluid flow. The most common tumors that occur near this area are tumors of the pineal region, such as pineoblastoma, pineocytoma or pineal germinoma. Because the pineal region lies in this area, just behind the midbrain where the aqueduct passes, growth of these tumors can compress and block the flow of fluid through the aqueduct.

Tumors occurring in other parts of the brain within or near the ventricles generally must be much larger to completely obstruct the flow of fluid since most of the ventricles are relatively large, irregularly-shaped structures. Some examples include tumors which are partially or entirely within the ventricles, such as an ependymoma, colloid cyst, medulloblastoma or choroid plexus papilloma or carcinoma.

What Types of Symptoms Are Typical?

Symptoms due to non-communicating hydrocephalus due to a brain tumor vary depending on the severity of hydrocephalus, the location of the tumor and other factors. However, if a brain tumor causes non-communicating hydrocephalus it can cause the typical symptoms associated with hydrocephalus of any cause, such as headache, nausea and/or vomiting and eventually deterioration of the level of consciousness leading to coma and death if severe and not treated. Some patients may also experience visual symptoms such as dysconjugate gaze or worsening of visual acuity with chronic hydrocephalus.

Depending on the type and location of the tumor, the tumor may cause other neurological symptoms unrelated to the hydrocephalus. These vary depending on which parts of the nervous system are affected by the growth of the tumor.

How Is The Diagnosis Typically Made?

In a patient who presents with symptoms typical of hydrocephalus and/or a brain tumor, a complete neurological assessment is generally performed. This generally includes an imaging study such as a CT scan or MRI scan.

An MRI scan with contrast is excellent at both evaluating hydrocephalus as well as detecting brain tumors. While the definitive diagnosis of the type of tumor may require a biopsy of the tumor tissue, the MRI can provide physicians much information about the tumor including location, size and other characteristics which may suggest what type of tumor it is.

What Are Some Common Treatments?

Treatment of tumor-associated non-communicating hydrocephalus varies from patient to patient depending on many factors. However, in general the treatment of hydrocephalus in these patients is the same as for any cause of obstructive hydrocephalus. For symptomatic patients, in general this means diverting the flow of cerebrospinal fluid with either a shunt procedure or endoscopic third ventriculostomy.

Most patients will require other medical or surgical treatments for the tumor. In some cases, surgical removal of the mass will relieve the pressure on the cerebrospinal fluid spaces within the brain and reverse the hydrocephalus. In others, despite treatment of the tumor the hydrocephalus may persist and require one of the above treatments for hydrocephalus.

Each patient with non-communicating hydrocephalus due to a brain tumor are different and therefore treatment plans cannot be recommended without carefully weighing the specifics of each case. Patients should discuss their appropriate treatment options with their own treating physicians.

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Important Note: This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.

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