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Fifth ventricle: an unusual cystic lesion of the conus medullaris

G Liccardo1, F Ruggeri, L De Cerchio

  • 1Neurosurgery, Department of Neuroscience, University of Rome Tor Vergata, 81-00133 Rome, Italy.

Spinal Cord
|January 19, 2005
PubMed
Abstract

Insights

A rare cystic dilatation of the fifth ventricle was identified in a patient with low back pain. This finding, confirmed by MRI, was stable over two years, leading to conservative management.

Area of Science:

  • Neurology
  • Radiology
  • Neuroanatomy

Background:

  • Cystic dilatation of the fifth ventricle is an exceptionally rare condition in adults with an unclear pathogenesis.
  • The fifth ventricle, also known as the terminal ventricle, is a midline cerebrospinal fluid (CSF)-filled space.
  • This case highlights a unique presentation of this rare entity.

Observation:

  • A 30-year-old woman presented with recurrent low back pain.
  • Comprehensive clinical, electrophysiological, and urodynamic assessments were unremarkable.
  • Magnetic Resonance Imaging (MRI) revealed a cyst in the lumbar-sacral region, consistent with a terminal ventricle, with no associated central nervous system malformations.

Findings:

  • The cyst was confirmed to be CSF-filled and did not enhance with gadolinium.
  • Serial MRI scans over two years showed no evolution of the lesion.
  • The patient's symptoms were deemed subjective, with no objective neurological deficits.

Implications:

  • The terminal ventricle should be considered in the differential diagnosis of conus medullaris lesions.
  • Conservative management is appropriate for stable, asymptomatic or subjectively symptomatic fifth ventricle cysts.
  • This case contributes to the understanding of rare cystic dilatations within the central nervous system.

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