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Third ventricular ependymal cyst presenting with acute hydrocephalus

Shigetoshi Yano1, Jun-ichiro Kuroda, Keishi Makino

  • 1Department of Neurosurgery, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University Graduate School, Kumamoto, Japan. yanos@kaiju.medic.kumamato-u.ac.jp

Pediatric Neurosurgery
|May 23, 2006
PubMed

Insights

A rare third ventricular ependymal cyst caused acute hydrocephalus in a child. Endoscopic resection successfully removed the cyst, resolving symptoms and improving cerebrospinal fluid circulation.

Area of Science:

  • Neuroscience
  • Pediatric Neurology
  • Neurosurgery

Background:

  • Ependymal cysts are typically found in the cerebral parenchyma, with rare occurrences in the third ventricle.
  • Third ventricular masses can lead to obstructive hydrocephalus and rapid neurological decline.

Observation:

  • A 4-year-old boy presented with acute symptoms including headache, vomiting, and upward gaze palsy, progressing to decreased consciousness.
  • Magnetic resonance imaging revealed a cystic mass in the third ventricle causing lateral ventricle dilation.

Findings:

  • The cystic mass originated from the lateral wall of the third ventricle, obstructing the aqueduct and causing hydrocephalus.
  • Histological examination confirmed the diagnosis of an ependymal cyst.
  • Neuroendoscopic resection of the cyst wall was performed.

Implications:

  • Third ventricular ependymal cysts, though rare, are a critical differential diagnosis for acute hydrocephalus in children.
  • Neuroendoscopic resection offers an effective treatment for third ventricular ependymal cysts, addressing cerebrospinal fluid circulation issues and enabling cyst wall removal.
  • This approach may be superior to traditional shunt placement for managing such conditions.

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