Expert: Claes-Gustaf Nordquist, M.D. - 3/19/2009

Question
My 33 year old son recently died from an undiagnosed brain tumor. No apparent symptoms, just the sudden death. The medical examiner said it caused an acute obstuctive hydrocephalus. We as a family have some indication of neurofibomatosis. Why no symptoms and is this a indication that he may have had a tumor for a long time?

Answer
I'm very sorry for your loss! It is possible. His tumor may have been slowly growing and benign (non cancerous) but so strategically located - quite possible in the 4th ventricle - that it when it reached a certain critical size blocked off the drainage of the cerebrospinal fluid there causing an acute hydrocephalus leading to his death. If that is the case it had probably been there for quite some time. If it had anything to do with neurofibromatosis (von Recklinghausen) I do not know but if the medical examiner did any microscopical studies of the tumor - should have been done - an answer to that should be obtainable from that source. If this was the case it would probably not give any symptoms until this happened. 1 cm. is not a large tumor (1 inch = 2.54 cm) especially if it is growing in the hollow fluid filled space of a ventricle where it by itself can not cause any neurological symptoms until this happened. I myself have a similar tumor (a subependymoma) in my right side ventricle. It was found by chance on an MRI brain scan of my brain done after my stroke a little more than 6 years ago that caused my retirement. It is not growing and is quite small and is not blocking the passage of fluid so I'm not doing anything about it. And it does not cause any symptoms whatsoever.