Department of Neurosurgery, Maria Cecilia Hospital, GVM Care & Research, Cotignola (Ravenna), Italy.
Department of Neurosurgery, Sant'Anna University Hospital Ferrara, Cona (Ferrara), Italy.
World Neurosurg. 2020 Nov;143:152-157. doi: 10.1016/j.wneu.2020.07.164. Epub 2020 Aug 1.
Choroid plexus cysts (CPCs) are a type of neuroepithelial cysts, benign lesions located more frequently in the supratentorial compartment. Symptomatic CPCs in the posterior fossa are extremely rare and can be associated with obstructive hydrocephalus.
A previously healthy elderly woman suffered intermittent attacks of headache and vomiting associated with gait instability. Magnetic resonance imaging documented a large cystic lesion occupying all the fourth ventricle. An endoscope-assisted fenestration of the lesion through a telovelar approach determined only temporary improvement, hence a second surgery with gross total resection of the cyst was performed, with successful long-term clinical and radiologic resolution. Histology revealed CPC.
Fourth ventricle symptomatic CPCs are extremely rare lesions, especially in the elderly. Their presence must be carefully evaluated as a possible rare cause of intermittent obstructive hydrocephalus. Even though cyst fenestration with restoration of the cerebrospinal fluid pathway represents the best treatment in the majority of cases, a more aggressive resection is sometimes necessary.
脉络丛囊肿（CPC）是一种神经上皮囊肿，多位于幕上腔，为良性病变。后颅窝有症状的 CPC 极为罕见，可伴有梗阻性脑积水。
一位既往健康的老年女性间断出现头痛和呕吐，并伴有步态不稳。磁共振成像显示第四脑室有一个大的囊性病变。通过穹隆间入路内镜辅助下对病变进行开窗术，仅暂时缓解症状，故行第二次手术，大体全切除囊肿，术后长期临床和影像学结果良好。组织学检查显示 CPC。
第四脑室有症状的 CPC 是极为罕见的病变，尤其是在老年人中。必须仔细评估其存在，因为它可能是间歇性梗阻性脑积水的罕见原因之一。尽管大多数情况下，囊肿开窗术以恢复脑脊液通路是最佳治疗方法，但有时需要更激进的切除。
