OPTIC CHIASM GLIOMA, ELECTROLYTE ABNORMALITIES, NONOBSTRUCTIVE HYDROCEPHALUS AND ASCITES

A 4-year-old girl with optic chiasm glioma (OCC), nonobstructive hydro cephalus and ventriculoperitoneal shunt is described, in whom marked a scites developed. The ascitic fluid was protein-rich and its amount co rrelated with cerebrospinal fluid (CSF) protein. The CSF protein level and the amount of ascitic fluid were influenced by chemotherapy. Very unusual hypernatremia, up to 190 mEq/l, with no associated alteration in mental status, was also found. it is suggested that altered absorp tion ability owing to the high protein content was the cause of both t he nonobstructive hydrocephalus and the ascites. The unusual well bein g with very high sodium concentrations may have resulted from osmorece ptor dysfunction, presumably caused by hypothalamic involvement as wel l as by the high CSF protein. This combination of findings may point t oward specific characteristics of OCG. In an effort to reduce the amou nt of the ascitic fluid, a further chemotherapeutic trial may be done, before converting the shunt to the vetriculoatrial system. (C) 1997 W iley-Liss, Inc.