Ependymoma: Recognizing Signs of Intracranial Hypertension and Effective Diagnostic Techniques Including MRI with Contrast and Tumor Biopsy

The ependymoma is a type of brain tumor that can present signs of intracranial hypertension due to its location and mass effect. These tumors, originating from the ependymal cells of the ventricular system, can obstruct the flow of cerebrospinal fluid, leading to hydrocephalus and increased intracranial pressure. Early identification of these symptoms is crucial for the appropriate management of the patient.

Diving Deeper into Ependymoma and Intracranial Hypertension

Symptoms of intracranial hypertension in patients with ependymoma may include headache, nausea, vomiting, and visual disturbances such as papilledema. A reported case highlights the importance of resolution of papilledema following treatment for increased intracranial pressure, underscoring the direct relationship between the tumor and neurological symptoms.

Effective diagnosis of an ependymoma and its associated complications, such as hydrocephalus, relies on advanced imaging techniques. MRI with contrast is an essential tool for identifying the presence and extent of the tumor. In one study, it was observed that MRI with contrast can reveal reversible vasogenic edema, which is crucial for differential diagnosis and treatment planning.

Furthermore, tumor biopsy remains the gold standard for confirming the histological diagnosis of ependymoma. In complex cases, such as those with spinal dissemination, open biopsy may be necessary to obtain an accurate diagnosis.

Conclusions

Management of ependymoma requires a multidisciplinary approach that combines early identification of signs of intracranial hypertension with advanced diagnostic techniques such as MRI with contrast and tumor biopsy. Understanding the underlying pathophysiology and applying timely surgical interventions, such as ventriculoperitoneal shunt, can significantly improve clinical outcomes in patients with obstructive hydrocephalus secondary to ependymoma.

Referencias

• [1] Spinal seeding of anaplastic ependymoma mimicking fungal meningitis. A case report and review of the literature.
• [2] Conventional and diffusion-weighted magnetic resonance imaging findings in a pediatric patient with a posterior fossa brain tumor and papilledema.
• [3] Posterior reversible encephalopathy syndrome (PRES): a rare condition after resection of posterior fossa tumors: two new cases and review of the literature.
• [4] Palliative ventriculoperitoneal shunting in dogs with obstructive hydrocephalus caused by tumors affecting the third ventricle.

Created 13/1/2025