Recurrent lumbar ependymoma presenting as headache and communicating hydrocephalus

We describe a patient with a recurrent spinal cord ependymoma who initially presented with symptoms of increased intracranial pressure rather than sym ptoms directly relating to involvement of the conus medullaris. Brain magne tic resonance imaging with gadolinium showed communicating hydrocephalus. M agnetic resonance imaging of the entire spinal cord with gadolinium reveale d recurrent tumor. Postoperatively, a permanent ventriculoperitoneal shunt was placed. Recognition of the association between spinal cord ependymoma a nd hydrocephalus is important in the evaluation of patients with headache.