Department of Neurosurgery, Military Medical Academy, Saint Petersburg, Russia.
Department of Neurosurgery, The Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia.
Neurosurg Rev. 2023 Oct 6;46(1):264. doi: 10.1007/s10143-023-02176-0.
Although choroid plexus cysts are a frequent incidental neuroimaging finding, symptomatic ones are rare-a series of more than five cases are hard to find. In the absence of high-volume studies, there are no generally accepted algorithms for diagnosis and treatment for this pathology. Proposed surgical techniques include microsurgical excision or fenestration and endoscopic excision or fenestration with or without additional shunting. No definitive conclusions exist about the superiority of a certain technique. Here, we introduce an illustrative case of a patient with a symptomatic choroid plexus cyst in the trigone of the lateral ventricle and a systematic review of 65 additional published cases with the aim of identifying epidemiological features, variants of localization of the cysts, their symptoms, persistence of concomitant obstructive hydrocephalus, and treatment modalities. A PRISMA-based literature search was performed on the PubMed, MEDLINE, Scopus, and Web of Knowledge databases. We include in the review case reports and case series of symptomatic choroid plexus cysts with full texts or valuable abstracts available online in English and published by April 2023. All abstracts of retrieved studies were assessed by two independent researchers to avoid bias. Only descriptive statistics were used for the presentation of the results. A total of 48 studies (39 case reports and 9 case series) with 65 depicted cases met the eligibility criteria. The review showed a slight predominance of choroid plexus cysts in men. The most common localizations of cysts were the trigone and the body of the lateral ventricle. Obstructive hydrocephalus is often present in patients with choroid plexus cysts. The most common symptoms of cysts were signs of increased ICP: headaches and vomiting. The main treatment approaches for symptomatic choroid plexus cysts were microsurgical excision, microsurgical fenestration, endoscopic fenestration, and total endoscopic excision. The tendency has been noted to shift from microsurgical to endoscopic procedures over the past two decades. Some data on the classification of cysts of the central nervous system and the underlying mechanisms of the pathogenesis of choroid plexus cysts are also presented.Although symptomatic cases of choroid plexus cysts are rare, by summarizing currently available data, one could clarify their common features and identify a preferable treatment modality.
尽管脉络丛囊肿是常见的偶然神经影像学发现，但有症状的囊肿却很少见-超过五例的系列病例很难找到。在没有大量研究的情况下，对于这种病理学，没有普遍接受的诊断和治疗算法。提出的手术技术包括显微切除术或开窗术以及内镜切除术或开窗术，可伴有或不伴有额外的分流术。关于某种技术的优越性尚无明确结论。在这里，我们介绍了一例有症状的侧脑室三角区脉络丛囊肿患者的病例，并对 65 例额外发表的病例进行了系统回顾，旨在确定流行病学特征、囊肿的定位变异、其症状、持续性伴发的梗阻性脑积水以及治疗方式。在 PubMed、MEDLINE、Scopus 和 Web of Knowledge 数据库中进行了基于 PRISMA 的文献检索。我们将有症状的脉络丛囊肿病例报告和病例系列纳入综述，这些病例报告和病例系列有全文或有价值的摘要可供在线查阅，并且均为英文，且发表于 2023 年 4 月之前。由两名独立的研究人员评估检索研究的所有摘要，以避免偏见。仅使用描述性统计来呈现结果。共有 48 项研究（39 项病例报告和 9 项病例系列）纳入 65 例描述性病例符合入选标准。综述显示，男性脉络丛囊肿略占优势。囊肿最常见的定位是侧脑室三角区和体部。梗阻性脑积水在脉络丛囊肿患者中很常见。囊肿最常见的症状是颅内压增高的迹象：头痛和呕吐。有症状的脉络丛囊肿的主要治疗方法是显微切除术、显微开窗术、内镜开窗术和全内镜切除术。在过去的二十年中，已经注意到从显微手术到内镜手术的转变趋势。还介绍了一些关于中枢神经系统囊肿分类和脉络丛囊肿发病机制的潜在机制的资料。虽然有症状的脉络丛囊肿很少见，但通过总结目前可用的数据，可以阐明其常见特征，并确定更可取的治疗方式。
