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Symptomatic cysts of the telencephalic choroid plexus
Insights
Symptomatic choroid plexus cysts are rare in children. A 9-year-old girl with headaches was successfully treated with surgical cyst removal, resolving her symptoms.
Area of Science:
- Pediatric Neurosurgery
- Neuropathology
Background:
- Symptomatic choroid plexus cysts of the telencephalon are uncommon pediatric neurological conditions.
- Most reported cases involve patients under 10 years of age.
Purpose of the Study:
- To review pertinent literature on symptomatic telencephalic choroid plexus cysts.
- To discuss a case of a 9-year-old girl with a symptomatic choroid plexus cyst.
Main Methods:
- Case presentation of a 9-year-old girl with suboccipital headaches.
- Diagnostic workup including physical examination, cerebrospinal fluid analysis, brain scan, electroencephalogram, and pneumoencephalogram.
- Surgical removal of the cyst via a transcallosal approach.
Main Results:
- The patient presented with headaches exacerbated by specific positions and early papilledema.
- Imaging revealed a mobile, pedunculated mass in the left trigone.
- Surgical excision of the cyst was successful, leading to complete symptom resolution.
Conclusions:
- Symptomatic choroid plexus cysts require prompt diagnosis and surgical intervention.
- The transcallosal approach is an effective method for removing such cysts.
- Early surgical management leads to favorable outcomes in pediatric patients.
Abstract:
Symptomatic cysts of the telencephalic choroid plexus are rare. This is a paediatric problem, with the oldest patient being 10 years old. Pertinent cases from the literature are reviewed. The case of a 9 year old girl with suboccipital headaches made more severe by lying on her right side or on her abdomen is discussed. Physical examination was within normal limits except for evidence of early papilloedema. The cerebrospinal fluid pressure was normal, and the protein was not elevated (32 mg/100 ml.). The brain scan showed a left frontoparietal mass near the midline, and the electroencephalogram was abnormal. The pneumoencephalogram demonstrated a mobile, pedunculated mass in the left trigone which approached the foramen of Monro when the patient assumed the head-erect position. A transcallosal approach was used and the cyst was easily removed. Postoperatively the patient has done well and is currently asymptomatic and without headaches. The significance of the presenting symptoms, the cerebrospinal fluid and brain scan findings, as well as the surgical approach, are discussed.