A 9-MONTH-OLD infant was admitted with a history of vomiting, irritability, poor feeding, and a fluctuating level of consciousness for 3 weeks prior to admission. Previously he could stand with support but on admission was very unsteady.
On physical examination he was well nourished with weight and length in the 50th percentile and head circumference of 48.2 cm, in the 97th percentile. His anterior fontanelle was small and normotensive. Generalized hypotonia was more marked in the legs than in the arms. Deep tendon reflexes were present and symmetrical. There was no focal neurological deficit. Pupils were equal and reacted to light. Ocular fundus examination revealed no papilledema.
As part of the initial workup, cranial computed tomography with intravenous contrast was performed (Figure).
Denouement and Discussion
Choroid Plexus Papilloma
Choroid plexus papillomas are benign neoplasms that arise from the ventricular choroid plexus. They are commonly associated with hydrocephalus and can hemorrhage
Arumugam R, Livingston J. Radiological Case of the Month. Arch Pediatr Adolesc Med. 1997;151(1):91-92. doi:10.1001/archpedi.1997.02170380095015