Symptomatic intraventricular choroid plexus cysts. Illustrative case and systematic review

Area of Science:

• Neuroscience
• Neurosurgery
• Radiology

Background:

• Choroid plexus cysts are common incidental findings on neuroimaging, but symptomatic cases are rare and lack established diagnostic/treatment algorithms.
• Existing literature lacks high-volume studies, necessitating a comprehensive review of available case data.

Approach:

• A PRISMA-based systematic literature review of PubMed, MEDLINE, Scopus, and Web of Knowledge databases was conducted.
• Included were case reports and series of symptomatic choroid plexus cysts published by April 2023, with abstracts assessed by two independent researchers.
• Descriptive statistics were used to analyze epidemiological features, cyst localization, symptoms, hydrocephalus, and treatment modalities from 65 cases across 48 studies.

Key Points:

• Slight male predominance observed in symptomatic choroid plexus cysts.
• Most common cyst locations are the trigone and body of the lateral ventricle.
• Obstructive hydrocephalus and symptoms like headaches and vomiting (indicating increased intracranial pressure) are frequent.
• Treatment options include microsurgical and endoscopic excision/fenestration, with a trend towards endoscopic approaches.

Conclusions:

• This review clarifies common features of symptomatic choroid plexus cysts, aiding in diagnosis and management.
• Endoscopic procedures show a growing preference over traditional microsurgical techniques for treating these rare cysts.