The diagnosis and treatment of cystic dilation of the ventriculus terminalis with 8 cases report

Abstract

Objective To study the diagnosis and treatment of cystic dilation of ventriculus terminalis (CDVT).Methods The clinical manifestations and MRI characteristics of 8 cases of CDVT treated from Jan.2006 to May.2013 were analyzed.Results There were 6 female and 2 male patients.The mean age of patient was 47.1 years old.The main symptoms were leg pain and spine cord compression.These lesions were spindle shaped,smooth walled,and without internal septae.The cystic contents had the same signal as cerebrospinal fluid on T1 and T2 MRI images,and without contrast enhancement.Two patients with Type Ⅰ (nonspecific complaints) symptoms were treated conservatively.The surgical treatment consisted of dorsolumbar laminotomy,myelotomy,and cyst-subarachnoid shunt placement.In patients with Type Ⅱ (focal neurological deficits) and Ⅲ (sphincter disturbances) symptoms,surgical treatment sustained improvement.Conclusions CDVT is a rare congenital lesion.MRI is the first choice of diagnosis technique.Adequate decompression and cyst-subarachnoid shunt placement are the optimal treatment.Treatment for Type Ⅰ lesion seems to be best conducted conservatively,whereas Types Ⅱ and Ⅲ seem to be best handled surgically. Key words: Cystic dilation of the ventriculus terminalis; Cyst-subarachnoid shunt; Microsurgery