Summary
Four patients are described presenting papilloedema, increased pressure and reduced CSF absorption—caused by either spinal tumours, leptomeningeal carcinomatosis or encephalitis. Remarkably they all had a normal CT without signs of hydrocephalus. A 24-hour intracranial pressure monitoring showed a mean pressure of 30–35 mm Hg, recurrent plateau waves and high occurrence of B waves. Conductance to CSF outflow studied by a constant perfusion test was severely reduced 0.010–0.026mlmin−1mm Hg−1 (normal > 0.12ml mm Hg−1 min−1). Despite these findings no ventricular enlargement was seen on serial CT scans. The reason therefore remains unknown. Disappearance of papilloedema and a variable clinical improvement followed shunt-insertion.
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Hansen, K., Gjerris, F. & Sørensen, P.S. Absence of hydrocephalus in spite of impaired cerebrospinal fluid absorption and severe intracranial hypertension. Acta neurochir 86, 93–97 (1987). https://doi.org/10.1007/BF01402291
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DOI: https://doi.org/10.1007/BF01402291