PMC9479627_01
Head computed tomography (CT) scan (a) and head magnetic resonance imaging (MRI; b) at onset showing enlargement of the ventricles. No typical disproportionately enlarged subarachnoid space hydrocephalus findings can be seen. There is no evidence of exacerbation of the hydrocephalus, such as enlargement of the ventricle, or over drainage on the head CT scan (c) when symptoms worsened.
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F1
The brain computed tomography (CT) and magnetic resonance (MR) studies confirmed enlarged ventricles without a brain tumor; she was diagnosed with non disproportionately enlarged subarachnoid space hydrocephalus (DESH: a form of NPH) [Figures 1a and b]. The brain CT confirmed the ventricular size remained unchanged [Figure 1c].
A cervical contrast-enhanced magnetic resonance imaging examination (a and b) showing a 1.4 x 9.0 x 2.3 cm neoplastic lesion (arrow) in the dura mater at the C5-C6 level. This is diagnosed as an intradural extramedullary tumor.
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F2
However, the cervical MR imaging (MRI) with contrast documented a benign intradural extramedullary lesion (i.e., 1.4 x 9.0 x 2.3 cm) at the C5-C6 level [Figure 2].
Histopathological examination of an intradural extramedullary tumor. (a) Photomicrograph showing a bundle of spindle-shaped cells, some of which have a shelf-like arrangement of nuclei. Hematoxylin and eosin staining, x100. (b) Immunohistochemical staining for S-100 protein showing strong and diffuse positive staining of the tumor cells. x400.
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F3
The entire cervical tumor mass was dissected away from the C6 nerve root; the lesion was positive for S-100 protein, confirming that it was a schwannoma [Figure 3].