Case report
Intracranial intradural chordoma presenting with intraventricular hemorrhage

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Introduction

Chordomas constitute 1% of intracranial tumors and are believed to originate from the remnant notochord. These tumors are usually located in the extradural bony structures of the base of the skull because they arise from the spheno-occipital synchondrosis and slowly erode the surrounding structures. However, some cases of intradural chordoma have been reported [1], [2]. To the best of our knowledge, there is no case report on intraventricular hemorrhage as an initial symptom of intradural chordoma.

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Case report

A 55-year-old woman presented with sudden severe headache and vomiting that had started one day earlier. Upon admission, the patient was in a stupor and the bilateral pupils were non-reactive to light. We found no signs of meningeal irritation or distinct focal neurological deficits. The features of panhypopituitarism, including diabetes insipidus, were discovered upon laboratory examination. Computed tomography (CT) showed a hemorrhage in the third ventricle and sellar space; however, there

Discussion

To the best of our knowledge, no previous reports have described an intradural chordoma with pure intraventricular hemorrhage. In the case presented here, the acute onset and gradual progression of symptoms mimic the typical course of intraventricular hemorrhage following obstructive hydrocephalus. In contrast, headache, disturbance of consciousness and features of panhypopituitarism are characteristics of pituitary apoplexy.

Only 26 cases of intradural intracranial chordoma have been reported

Conclusion

Intradural chordoma with hemorrhagic presentation is a rare event. The operative and histopathological findings support the dural invasion of the tumor as the cause of the hemorrhage.

Conflict of interest

The authors disclose no direct or indirect conflicts of interest.

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  • E. Ito et al.

    Intradural cranial chordoma

    Surg Neurol

    (2009)
  • T. Uda et al.

    An intradural skull base chordoma presenting with acute intratumoral hemorrhage

    Neurol India

    (2006)
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