Abstract
A 4-month-old girl was hospitalized in 1975 because of vomiting. The anterior fontanelle was tense and bulging. She showed no abnormal neurological signs. Ventriculography showed the right lateral ventricle larger than the left. No mass was seen within the ventricles. A ventriculo-peritoneal (V-P) shunt was performed. After the operation the patient showed no signs of increased intracranial pressure for six years. The child was admitted with severe headache and vomiting in 1981. Roentgenograms disclosed disruption of the Holter valve. She showed normal physical and mental development. Computed tomography (CT) scan revealed enlarged ventricles with a contrast enhanced mass within the trigone of the right lateral ventricle. A right parietotemporal craniotomy was performed, the tumor was totally removed, and the shunt system was disposed of. The pathological diagnosis was benign choroid plexus papilloma. The child made an uneventful and rapid recovery. A neurological examination 4 years after the operation gave normal findings, and a CT scan showed a normal ventricular system. The tumor did not directly obstruct the flow of the cerebrospinal fluid; tumor removal alone was sufficient to stop the progression of hydrocephalus, and no shunt was necessary. This case supports the concept that hyperproduction of cerebrospinal fluid is sufficient to cause communicating hydrocephalus in patients with choroid plexus papilloma of the lateral ventricle.
