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Recurrent terminal ventricle cyst: a case report.

Asfand Baig Mirza¹, Ravindran Visagan¹, Timothy Boardman²

¹Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, UK.

Journal of Surgical Case Reports

|November 22, 2021

Summary

A rare cyst in the spinal cord, the terminal ventricle (TV) of Krause, can cause symptoms like paralysis. This case shows a TV cyst can spontaneously rupture, leading to rapid symptom resolution, suggesting a variable natural history.

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Area of Science:

Neurology
Neurosurgery
Radiology

Background:

Terminal ventricle (TV) of Krause is a rare cystic dilation of the conus medullaris central canal.
Pathophysiology and optimal management of TV of Krause remain poorly understood and controversial.

Observation:

A 25-year-old female presented with acute paraparesis.
MRI revealed a cystic conus medullaris lesion consistent with a TV of Krause.

Findings:

The patient experienced rapid and complete resolution of her paraparesis.
The authors hypothesize spontaneous rupture and auto-decompression of the TV of Krause cyst.

Implications:

This case represents the first report of an enlarging symptomatic TV of Krause cyst with spontaneous resolution.
Highlights the variable natural history of terminal ventricle cysts.
Suggests conservative management may be viable in select cases of symptomatic TV of Krause.