Introduction
The clinical manifestations of obstructive hydrocephalus vary with the age of the patient, duration of the condition, and
etiology of the hydrocephalus.
Case report
A 14-year-old boy presented with diurnally fluctuating dysarthria, dysequilibrium of the gait, and retropulsion, probably
due to transient obstruction by a tumor at the entrance of the cerebral aqueduct of the pineal region. This fluctuation was
ascertained clinically by assessing the ICARS score 5 h after the patient was in the supine and erect positions.
Conclusion
This result suggests that the symptoms of hydrocephalus are possibly associated with a check-valve mechanism of the pineal
tumor and may be related to transient compression of the basal ganglia and frontal lobes.
Keywords Frontal dysequilibrium - Fluctuation - Pineal region - Tumor - Check-valve