Blinking—an unusual presentation of obstructive hydrocephalus relieved by endoscopic third ventriculostomy

Excerpt

A 9-year-old girl presented with symptoms and signs of raised intracranial pressure over a period of 10 days. In addition, she had persistent fast blinking. The onset of this persistent blinking corresponded with the onset of symptoms of raised intracranial pressure. On examination, her corrected visual acuity was normal; however, bilateral papilloedema was present. There was no upgaze palsy. An urgent computerised tomographic (CT) scan identified dilatation of the lateral and third ventricles with associated periventricular lucency. Magnetic resonance imaging (MRI) of the brain revealed obstructive hydrocephalus due to a lesion of the tectal plate. (Figure 1a and b). The radiological features of the tectal plate lesion were consistent with a tectal plate glioma.

…