Fondazione Policlinico Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy.
Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Acta Neurochir Suppl. 2023;135:395-397. doi: 10.1007/978-3-031-36084-8_60.
The ventriculus terminalis (VT), also called the fifth ventricle, is a small cavity containing cerebrospinal fluid (CSF) that is in the conus medullaris in continuity with the central canal of the spinal cord. In adults, persistent VT is a very rare entity, and the diagnosis is incidental in most cases. Rarely, VT may become symptomatic for still-uncertain reasons but most often for its cystic dilatation. The management of these selected cases is still controversial and sometimes associated with unsatisfactory outcomes.
We performed a critical review of the existing literature on the management of symptomatic VT in adults. The etiology, pathophysiology, and treatment of VT are presented and discussed, focusing on the best timing for surgery.
Conservative management, marsupialization, or the placement of a T drain have been reported. The existing classifications describe the most correct approach for each clinical presentation, but scarce importance has been given to the delay from symptoms' onset to surgical treatment.
Although different cases have been described in the literature, this rare pathology remains unknown to most neurosurgeons.
终室（VT），也称为第五脑室，是一个充满脑脊液（CSF）的小腔，位于延髓圆锥内，与脊髓中央管连续。在成人中，持续性 VT 非常罕见，大多数情况下诊断为偶发。罕见情况下，VT 可能由于尚未确定的原因出现症状，但通常是由于其囊性扩张。这些精选病例的治疗仍存在争议，有时治疗结果并不令人满意。
我们对成人症状性 VT 管理的现有文献进行了批判性回顾。介绍并讨论了 VT 的病因、病理生理学和治疗，重点讨论了手术的最佳时机。
保守治疗、开窗术或 T 型引流管的放置已有报道。现有的分类描述了每种临床表现的最正确方法，但对从症状出现到手术治疗的延迟重视不足。
尽管文献中描述了不同的病例，但这种罕见的病理变化大多数神经外科医生并不了解。
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