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Symptomatic third ventricular choroid plexus cysts.

A H Lam1, A C Villanueva

  • 1Department of Radiology, Children's Hospital, Camperdown, Sydney, Australia.

Pediatric Radiology
|January 1, 1992
PubMed
Summary
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Choroid plexus cysts (CPC) at the foramen of Monro can cause obstructive hydrocephalus in children. Cranial sonography and CT-ventriculography are recommended for diagnosis, while standard CT and MRI may miss these cysts.

Area of Science:

  • Pediatric Radiology
  • Neuroimaging
  • Pediatric Neurosurgery

Background:

  • Choroid plexus cysts (CPC) are common intraventricular lesions in children.
  • When located at the foramen of Monro, CPC can obstruct cerebrospinal fluid (CSF) flow, leading to obstructive hydrocephalus and increased intracranial pressure.
  • Accurate diagnosis is crucial to avoid misdiagnosis and inappropriate treatment, such as unnecessary shunting.

Purpose of the Study:

  • To describe the imaging findings of choroid plexus cysts at the foramen of Monro in children.
  • To evaluate the effectiveness of different imaging modalities in diagnosing these cysts.
  • To highlight the clinical significance of obstructive CPC and guide appropriate management.

Main Methods:

  • Retrospective review of imaging studies (cranial sonography, CT-ventriculography, CT, MRI) in three children with symptomatic CPC at the foramen of Monro.

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  • Correlation of imaging findings with clinical presentation and outcomes.

    • Main Results:

    • All symptomatic CPC measured less than 2 cm.
    • Cranial sonography and CT-ventriculography accurately depicted the CPC and associated ventriculomegaly.
    • Standard CT and MRI failed to visualize the CPC in these cases.
    • Two patients experienced symptom relief after surgical resection of the cyst.

    Conclusions:

    • Cranial sonography and CT-ventriculography are the imaging modalities of choice for evaluating ventriculomegaly when obstructive CPC is suspected in children.
    • Cranial sonography is indicated for infants with open fontanelles, while CT-ventriculography is reserved for older children with hydrocephalus unresponsive to shunting.
    • Prompt and accurate diagnosis of obstructive CPC is essential to prevent adverse outcomes associated with misdiagnosis and delayed treatment.