Neuroepithelial Cysts of the lllrd Ventricle as a Cause of Hydrocephalus

 

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Abstract

In case of hydrocephalus, a direct operation on the lesion that causes the block is superior to any type of shunt. A rare cause of hydrocephalus is a cyst of the septum pellucidum. Three patients - 2 years, 6 years and 20 years of age - are presented. All had slowly developed symptoms of increased intracranial pressure and the two children manifested retardation of their motor skills. Carotid angiography in the children disclosed a hydrocephalus, as did CT in the adult patient. Ventriculography through a frontal burr-hole was done in all cases. Fluid could be easily injected but only a few drops of fluid could be drawn out. The ventriculogram showed a large round smooth expansion in the IIIrd ventricle extending into both lateral ventricles. A transfrontal resection of the cyst wall was done. The cyst contained clear fluid with higher protein content than the ventricular CSF. All three patients have done well, have shown no signs of increased intracranial pressure, and did not need a shunt. The development of the two children has been normal. All three cases had the same histological findings as with neuro-epithelial cysts.

Zusammenfassung

Als seltene Ursache des Hydrozephalus werden 3 Zysten des Septum pellucidum bei Patienten im Alter von 2, 6 und 20 Jahren beschrieben. Alle entwickelten langsam Zeichen des allgemein gesteigerten Hirndrucks, die 2 Kinder wiesen motorische Einbußen auf. Ventrikulographisch zeigte sich eine große runde, fließende Ausdehnung in dem III. Ventrikel mit Eindringen in beide Scitenventrikel.

Flüssigkeit konnte leicht injiziert, aber kaum aspiriert werden. Der Eiweißgchalt war erhöht. Die Operation bestand in einer transfrontalen Resektion der Zystenwand, ohne daß ein Shunt benötigt wurde. Alle 3 Fälle erwiesen sich histologisch als neuro-epitheliale Zysten.