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Journal of Pediatric Neurology 2012; 10(01): 041-044
DOI: 10.3233/JPN-2012-0525
Georg Thieme Verlag KG Stuttgart – New York

Primary amenorrhea in a 17-year-old patient with chronic hydrocephalus from an ependymoma

Sunny H. Jun
a   Department of Reproductive Endocrinology and Fertility, Palo Alto Medical Foundation, Fremont, CA, USA
,
Brooke E. Friedman
b   Department of Reproductive Endocrinology and Infertility, Stanford University Hospital, Stanford, CA, USA
,
Laura M. Gandrud
c   Department of Pediatric Endocrinology, Children's Hospitals and Clinics of Minnesota, Paul, MN, USA
,
Lynn M. Westphal
b   Department of Reproductive Endocrinology and Infertility, Stanford University Hospital, Stanford, CA, USA
› Author Affiliations
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Publication History

01 January 2010

17 September 2010

Publication Date:
30 July 2015 (online)

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Abstract

In here, we describe a case of primary amenorrhea in the setting of chronic hydrocephalus caused by a posterior fossa ependymoma. A 17-year-old female with primary amenorrhea presented to University-affiliated teaching hospital. Hormonal studies were all normal. Cranial magnetic resonance imaging revealed chronic hydrocephalus with a 4 cm brain lesion that was determined to be an ependymoma. After surgical resection, the patient had normal menstrual cycles. Primary amenorrhea in association with hydrocephalus is usually due to hypothalamic hypogonadism. We report a case of an adolescent female with normal gonadotropin levels and chronic hydrocephalus who presented with primary amenorrhea. Even in the presence of normal hormonal studies and withdrawal bleeding after a progestational challenge, a head magnetic resonance imaging should be performed in all females who do not have hypergonadotropic amenorrhea.

Keywords

Amenorrhea - hydrocephalus - hypothalamic hypogonadism - ependymoma