Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University New York, and Department of Neurosurgery, Millard Fillmore Gates Hospital, Kaleida Health, Buffalo, New York, USA.
Neurosurgery. 2010 Jun;66(6 Suppl Operative):376-7; discussion 377. doi: 10.1227/01.NEU.0000369186.99306.E0.
Choroid plexus cysts are common in the developing fetus, and although often persisting into adulthood, they rarely represent the underlying cause of symptomatic unilateral ventriculomegaly. The case presented here highlights both the diagnostic obscurity and endoscopic management of a choroid plexus cyst in a symptomatic patient.
The patient is a 47-year-old white woman who presented with acute exacerbation of debilitating, diffuse, and postural headache, nausea, vomiting, early papilledema, and short-term memory loss. Cranial magnetic resonance imaging revealed an intraventricular mass obstructing the foramen of Monro on the left with ventriculomegaly. Cranial computed tomographic imaging demonstrated unilateral ventricular enlargement.
During stereotactic endoscopic exploration, a choroid plexus cyst was evident at the foramen of Monro. Endoscopic cauterization of the cyst resulted in a decrease in the size of the left lateral ventricle, with complete relief of the patient's headaches and resolution of her memory loss. She remained headache free at the time of a 3-year follow-up evaluation after surgery.
Choroid plexus cysts remain a diagnostic challenge; their presence should be sought out in the face of ventricular asymmetry and symptomatic hydrocephalus. Endoscopic ablation offers a minimally invasive treatment for the management of these lesions.
脉络丛囊肿在发育中的胎儿中很常见，尽管它们通常会持续到成年期，但很少成为症状性单侧脑积水分流术的根本原因。本文介绍的病例突出了脉络丛囊肿在有症状患者中的诊断模糊性和内镜治疗。
患者为 47 岁白人女性，表现为进行性加重的衰弱性、弥漫性和姿势性头痛、恶心、呕吐、早期视乳头水肿和短期记忆丧失。头颅磁共振成像显示左侧室间孔处有脑室肿块，伴有脑室扩大。头颅计算机断层扫描显示单侧脑室扩大。
立体定向内镜探查时，发现室间孔处有脉络丛囊肿。囊肿的内镜烧灼导致左侧外侧脑室缩小，患者头痛完全缓解，记忆丧失也得到改善。术后 3 年随访时，她仍无头痛。
脉络丛囊肿仍然是一个诊断挑战；在出现脑室不对称和症状性脑积水时，应寻找其存在。内镜消融术为这些病变的治疗提供了一种微创治疗方法。
