Gangemi M, Donati P, Maiuri F, Sigona L
Department of Neurosurgery, School of Medicine, University Federico II, Naples, Italy.
Surg Neurol. 1997 Feb;47(2):134-6; discussion 136-7. doi: 10.1016/s0090-3019(96)00367-9.
The cavum veli interpositi is a not infrequent radiologic finding in both children and adults, as confirmed by computed tomography (CT) and magnetic resonance (MR). A moderate enlargement of the cavum may sometimes be observed; on the other hand, a true large cyst may be considered exceptional, with only one reported case.
This 9-year-old boy with psychomotor retardation and epileptic seizures had a large CSF cyst in the region of the cavum veli interpositi, diagnosed by CT and MR. The patient was treated by endoscopic surgery, with introduction of the endoscope into the occipital horn of the right lateral ventricle and multiple fenestrations from the right ventricle to the cyst, and then from the cyst to the left lateral ventricle. The surgery resulted in decrease in the size of the cyst and reduction of the frequency of seizures.
Children with dilated or cystic cavum veli interpositi present with a large head, mental retardation, seizures, and hydrocephalus. On CT and MR, the cyst shows a typical triangular configuration on the axial plane and lies on the roof of the third ventricle in the coronal plane. Endoscopic ventricular fenestration is the treatment of choice for these as well as all other intraventricular and intracerebral CSF cysts, because it ensures communication between the cyst and the ventricular system and avoids definitive shunting of the cyst.
经计算机断层扫描（CT）和磁共振成像（MR）证实，中脑导水管周围囊肿在儿童和成人中都是一种常见的影像学表现。有时可观察到囊肿适度增大；另一方面，真正的大囊肿则较为罕见，仅有一例报道。
这名9岁男孩有精神运动发育迟缓及癫痫发作，经CT和MR诊断，其在中脑导水管周围区域有一个大的脑脊液囊肿。患者接受了内镜手术治疗，将内镜经右侧脑室枕角置入，从右侧脑室向囊肿多处开窗，然后从囊肿向左侧脑室开窗。手术使囊肿体积减小，癫痫发作频率降低。
中脑导水管周围囊肿扩张或呈囊性的儿童表现为头颅增大、智力发育迟缓、癫痫发作和脑积水。在CT和MR上，囊肿在轴位平面呈典型的三角形形态，在冠状位平面位于第三脑室顶部。对于这些以及所有其他脑室内和脑内脑脊液囊肿，内镜下脑室开窗术是首选治疗方法，因为它能确保囊肿与脑室系统相通，避免对囊肿进行永久性分流。
