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Washington University Experience | NEOPLASMS (GLIAL) | Ependymoma - Gross & Microscopic | 4A0 Case 4 History
Case 4 History ---- This 36 year old patient was readmitted to BH complaining of dizzy spells, tension headaches, and depression of one to two years duration. A CT scan at an OSH approximately 1 yr prior to this admission was normal. Approximately 6 wks prior to this admission the patient began to complain of chronic fatigue and decreased libido. A CT scan at that time 5/22 revealed marked hydrocephalus associated with a mass in the posterior fossa. A ventriculogram was performed on 5/26/78 which showed obstruction in the 4th ventricle. A large tumor was found to be arising from the medulla and extending well up into the 4th ventricle and downward to the level of the arch of C1. A subtotal resection was performed and a ventricular atrial shunt was placed. Postoperatively the patient remained alert and showed persistent ataxia and nystagmus. He continued to be bothered by hiccups. The patient was started on radiation therapy, 5500 rads in 6 wks. He was readmitted to the neurosurgical service on 7/24 with a 4 day history of dysphagia and was discharged on 7/27 on Decadron. He continued to have dysphagia, nystagmus, and ataxia. His depression persisted and the patient gradually developed symptoms of steroid myopathy.
