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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
Summary
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.