Mansour Moustafa A, Issa Saied A, Ayoub Basim, Abdelwahab Moataz
Department of Neurosurgery, Nasser Institute for Research and Treatment, Cairo, Egypt.
Department of Neurosurgery, Faculty of Medicine, Helwan University, Cairo, Egypt.
Radiol Case Rep. 2025 Jun 26;20(9):4610-4615. doi: 10.1016/j.radcr.2025.05.087. eCollection 2025 Sep.
Epidermoid cysts of the lateral ventricle are rare, benign intracranial lesions originating from ectopic embryonic epithelial cells, comprising only 0.2% of intracranial neoplasms. Although often asymptomatic initially, they may eventually cause mass effects or cerebrospinal fluid (CSF) obstruction as they enlarge. Accurate diagnosis-typically achieved via diffusion-weighted imaging (DWI)-is essential, as these cysts can mimic other intraventricular pathologies. Surgical resection remains the definitive treatment, though their deep-seated location and proximity to critical neurovascular structures pose significant challenges. This series describes 3 cases of lateral ventricle epidermoid cysts in patients presenting with progressive symptoms, including headaches, visual deficits, and neurological impairments, consistent with elevated intracranial pressure. Preoperative imaging, notably DWI, confirmed the diagnoses by demonstrating characteristic restricted diffusion. Near-total resection was achieved using microsurgical and endoscopic techniques, preserving vital structures and resulting in favorable postoperative outcomes with symptom resolution. However, 1 patient experienced persistent visual deficits due to delayed intervention. Advanced imaging, particularly DWI, is indispensable for precise diagnosis, while combined microscopic-endoscopic approaches optimize resection and reduce neurological risks. Early diagnosis and tailored surgical strategies are crucial for optimal outcomes. This series underscores the need for standardized management guidelines and identifies barriers to long-term follow-up, such as financial constraints.
侧脑室表皮样囊肿是一种罕见的颅内良性病变，起源于异位胚胎上皮细胞，仅占颅内肿瘤的0.2%。虽然最初通常无症状，但随着囊肿增大，它们最终可能导致占位效应或脑脊液（CSF）梗阻。准确诊断通常通过扩散加权成像（DWI）实现，这至关重要，因为这些囊肿可能模仿其他脑室内病变。手术切除仍然是 definitive 治疗方法，尽管其深部位置以及与关键神经血管结构的接近程度带来了重大挑战。本系列描述了3例侧脑室表皮样囊肿患者，他们出现了进行性症状，包括头痛、视力缺陷和神经功能障碍，与颅内压升高一致。术前成像，尤其是DWI，通过显示特征性的扩散受限证实了诊断。使用显微外科和内镜技术实现了近全切除，保留了重要结构，并在症状缓解的情况下取得了良好的术后效果。然而，1例患者由于干预延迟出现了持续的视力缺陷。先进的成像技术，尤其是DWI，对于精确诊断不可或缺，而显微内镜联合方法可优化切除并降低神经风险。早期诊断和量身定制的手术策略对于实现最佳结果至关重要。本系列强调了标准化管理指南的必要性，并确定了长期随访的障碍，如经济限制。
