Zeinali Masoud, Safari Hosein, Rasras Saleh, Bahrami Reza, Arjipour Mahdi, Ostadrahimi Nima
a Department of Neurosurgery , Ahvaz Jundishapur University Of Medical Sciences , Ahvaz , Iran.
Br J Neurosurg. 2019 Jun;33(3):294-298. doi: 10.1080/02688697.2017.1340585. Epub 2017 Jun 15.
The ventriculus terminalis (VT) is a small ependyma-lined cavity within the conus medullaris that is in direct continuity with the central canal of the spinal cord. Cystic dilatation of the ventriculus terminalis on its own is an extremely rare pathological event in adults whose pathogenesis is uncertain. VT has been described in children as a normal developmental phenomenon. These lesions are often diagnosed incidentally during imaging and are in most cases asymptomatic, especially in children. Symptomatic dilatation of VT in adults is a rare condition with 61cases being reported to date. Symptomatic dilatation of VT in children has not been reported till now. We present a 5 year-old-boy with a sphincteric and walking disorder. The patient was assessed by clinical, electrophysiological and urodynamic investigations as well as magnetic resonance imaging (MRI) of the lumbar-sacral segment with and without gadolinium enhancement. Lumbar-sacral MRI demonstrated the presence of a cystic lesion containing cerebrospinal fluid (CSF), which did not enhance after gadolinium, compatible with the diagnosis of the ventriculus terminalis dilation.The patient underwent laminectomy and the cyst wall was fenestrated with a midline myelotomy. In 6-month of follow-up, urinary problems and gait disturbance improved.
终室（VT）是脊髓圆锥内一个内衬室管膜的小腔隙，与脊髓中央管直接相连。终室的囊性扩张在成人中是一种极其罕见的病理事件，其发病机制尚不清楚。在儿童中，终室被描述为一种正常的发育现象。这些病变常在影像学检查时偶然发现，大多数情况下无症状，尤其是在儿童中。成人终室的症状性扩张是一种罕见疾病，迄今为止报道了61例。儿童终室的症状性扩张目前尚未见报道。我们报告一名5岁男孩，患有括约肌功能障碍和行走障碍。通过临床、电生理和尿动力学检查以及腰骶段磁共振成像（MRI）（有无钆增强）对该患者进行了评估。腰骶部MRI显示存在一个含有脑脊液（CSF）的囊性病变，钆增强后无强化，符合终室扩张的诊断。该患者接受了椎板切除术，囊肿壁通过中线脊髓切开术开窗。在6个月的随访中，泌尿问题和步态障碍有所改善。
