Ruptured Massa Intermedia Secondary to Hydrocephalus

World Neurosurg. 2017 Jan:97:749.e7-749.e10. doi: 10.1016/j.wneu.2016.10.131. Epub 2016 Nov 4.

Abstract

Background: We report a case of ruptured massa intermedia (MI) as a sequela of hydrocephalus.

Case description: A single case report is presented describing the sequelae of tumor bed hematoma after a posterior fossa hemangioblastoma resection in which the patient bled 3 days after surgery, resulting in secondary hydrocephalus and subsequently dilatation of the third ventricle, which resulted in rupture of the MI. The patient was managed on emergency basis with an external ventricular drain then endoscopically with a third ventriculostomy and clot extraction.

Conclusions: Absent MI is not uncommon in hydrocephalic patients, and it is assumed to be the result of rupture from acute dilatation of the third ventricle. Our case report proves this assumption and documents the presence and absence of the MI before and after developing hydrocephalus.

Keywords: Endoscopic third ventriculostomy; Hemangioblastoma; Hydrocephalus; Massa intermedia.

Publication types

  • Case Reports

MeSH terms

  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / surgery*
  • Endoscopy
  • Hemangioblastoma / diagnosis*
  • Hemangioblastoma / surgery*
  • Humans
  • Hydrocephalus / diagnosis
  • Hydrocephalus / etiology*
  • Hydrocephalus / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / complications*
  • Postoperative Hemorrhage / diagnosis
  • Postoperative Hemorrhage / surgery*
  • Rupture, Spontaneous
  • Skull Base Neoplasms / diagnosis*
  • Skull Base Neoplasms / surgery*
  • Third Ventricle / surgery*
  • Ventriculostomy