The Slowly Enlarging Ventriculus Terminalis.

Area of Science:

• Neurology
• Neurosurgery
• Spinal Imaging

Background:

• The ventriculus terminalis (VT), or fifth ventricle, is a CSF cavity within the conus medullaris.
• VT is often an incidental finding on lumbar spine MRI but can be associated with neurological deficits.
• VT lesions are typically stable or regressing, though enlargement can occur with trauma or spinal deformities.

Observation:

• A case of a slowly growing VT was identified in a female patient.
• The patient presented with progressive lower limb weakness.
• No history of trauma or spinal abnormalities was noted.

Findings:

• Surgical fenestration of the VT led to complete symptomatic relief.
• Two-year follow-up imaging showed no evidence of VT recurrence.
• This represents the first reported case of a slowly enlarging VT without associated trauma or spinal abnormalities.

Implications:

• This case highlights a rare etiology of progressive neurological symptoms.
• Surgical intervention can be effective for symptomatic VT.
• Further research may elucidate the pathogenesis of spontaneously enlarging VTs.