Computed Tomography in Diagnosis of Intracranial Tumors versus Tubers in Tuberous Sclerosis

Intraventricular gliomas producing obstruction of the foramen of Monro were observed by computed tomography in 4 of 8 patients with tuberous sclerosis. Bilateral tumors arising from the caudate nuclei were present in one patient. Characteristic subependymal calcified tubers were also seen, but contrast enhancement occurred only in the tumors and not in the tubers. The location of the tumor prevented communication between the 2 lateral ventricles so that surgical placement of a single ventricular shunt resulted in only unilateral relief of hydrocephalus. Shunting in one case was ineffective because of high cerebrospinal fluid viscosity due to elevated protein concentration.