Endoscopic management of a choroid plexus cyst of the third ventricle: case report and documentation of dynamic behavior

• Published in: Child's nervous system Vol. 31; no. 5; pp. 815 - 819
• Main Authors: Azab, Waleed A., Mijalcic, Radovan M., Aboalhasan, Ali A., Khan, Tufail A., Abdelnabi, Ehab A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-05-2015
• Subjects: Case Report; Central Nervous System Cysts - pathology; Central Nervous System Cysts - surgery; Cerebral Ventricle Neoplasms - pathology; Cerebral Ventricle Neoplasms - surgery; Child; Choroid Plexus Neoplasms - pathology; Choroid Plexus Neoplasms - surgery; Humans; Male; Medicine; Medicine & Public Health; Neuroendoscopy - methods; Neurosciences; Neurosurgery; Third Ventricle - pathology; Third Ventricle - surgery; Treatment Outcome; Ventriculostomy - methods; Choroid plexus cyst; Endoscopic third ventriculostomy; Endoscopic ablation
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-015-2649-y

Purpose
The aim of this study is to document the dynamic behavior of a choroid plexus cyst of the third ventricle. Although these lesions may float freely within the ventricle leading to intermittent obstruction of the cerebrospinal fluid (CSF) circulation at variable points in a single patient, such a phenomenon has only been documented using cranial ultrasonography and was never observed intraoperatively.
Methods
We endoscopically treated a case of third ventricular choroid plexus cyst in a 9-year-old boy who presented with headaches and disturbed conscious level. He underwent a transventricular approach through a single burr hole.
Results
During the procedure, the cyst was noted to intermittently herniate into the lateral ventricle and recede back through the foramen of Monro. Endoscopic ablation of the cyst was achieved and followed by endoscopic third ventriculostomy (ETV). The patient made an excellent recovery after the procedure.
Conclusions
We were able to endoscopically observe the dynamic behavior displayed by a choroid plexus cyst of the third ventricle. To the best of our knowledge, intraoperative documentation of the obstruction of the CSF pathway by a single choroid plexus cyst that intermittently herniates through the foramen of Monro and back into the third ventricular cavity has not been previously demonstrated neither microsurgically nor endoscopically.