Cystic Dilation of the Conus Ventriculus Terminalis Presenting as an Acute Cauda Equina Syndrome Relieved by Decompression and Cyst Drainage: Case Report
OBJECTIVE AND IMPORTANCE:The ventriculus terminalis of the conus, or "fifth ventricle" refers to the ependymal-lined space in the middle of the conus that is present in childhood and whose persistence into adulthood is rare. A number of cases of cystic dilatation of the ventriculus termina...
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Veröffentlicht in: | Neurosurgery 2006-03, Vol.58 (3), p.E585-E585 |
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creator | Brisman, Jonathan L. Li, Maria Hamilton, Dean Mayberg, Marc R. Newell, David W. |
description | OBJECTIVE AND IMPORTANCE:The ventriculus terminalis of the conus, or "fifth ventricle" refers to the ependymal-lined space in the middle of the conus that is present in childhood and whose persistence into adulthood is rare. A number of cases of cystic dilatation of the ventriculus terminalis have been described in adulthood. Patients tend to present with either pain alone or gradually progressive conus or cauda equina syndromes with varying degrees of recovery after cyst drainage. Presentation with an acute cauda equina syndrome and its successful surgical management has not been previously reported.
CLINICAL PRESENTATION:A 57-year-old woman experienced back pain and bilateral sciatica ascribed to diabetic neuropathy for 2 years. Over a 24-hour period she developed bilateral lower extremity weakness, saddle anesthesia, and bowel and bladder incontinence. Lumbosacral magnetic resonance imaging demonstrated a large cystic dilatation of the ventriculus terminalis.
INTERVENTION:She was taken for emergency surgical decompression and cyst drainage. Immediately after surgery, she experienced significant increase in lower extremity strength and has since regained continence.
CONCLUSION:Cystic dilation of the ventriculus terminalis should be part of the differential diagnosis for a cauda equina syndrome; surgical decompression with simple cyst drainage can result in excellent clinical results. |
doi_str_mv | 10.1227/01.neu.0000197486.65781.88 |
format | Article |
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CLINICAL PRESENTATION:A 57-year-old woman experienced back pain and bilateral sciatica ascribed to diabetic neuropathy for 2 years. Over a 24-hour period she developed bilateral lower extremity weakness, saddle anesthesia, and bowel and bladder incontinence. Lumbosacral magnetic resonance imaging demonstrated a large cystic dilatation of the ventriculus terminalis.
INTERVENTION:She was taken for emergency surgical decompression and cyst drainage. Immediately after surgery, she experienced significant increase in lower extremity strength and has since regained continence.
CONCLUSION:Cystic dilation of the ventriculus terminalis should be part of the differential diagnosis for a cauda equina syndrome; surgical decompression with simple cyst drainage can result in excellent clinical results.</description><identifier>ISSN: 0148-396X</identifier><identifier>EISSN: 1524-4040</identifier><identifier>DOI: 10.1227/01.neu.0000197486.65781.88</identifier><identifier>PMID: 16528154</identifier><identifier>CODEN: NRSRDY</identifier><language>eng</language><publisher>Hagerstown, MD: Copyright by the Congress of Neurological Surgeons</publisher><subject>Biological and medical sciences ; Decompression, Surgical - methods ; Diagnosis, Differential ; Dilatation, Pathologic - diagnosis ; Dilatation, Pathologic - surgery ; Drainage - methods ; Female ; Humans ; Medical sciences ; Middle Aged ; Nerve Compression Syndromes - diagnosis ; Nerve Compression Syndromes - surgery ; Neurosurgery ; Polyradiculopathy - diagnosis ; Polyradiculopathy - surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><ispartof>Neurosurgery, 2006-03, Vol.58 (3), p.E585-E585</ispartof><rights>Copyright © by the Congress of Neurological Surgeons</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3594-b45418eb0bc4393b7e7402efdc5d2506e971b712de321b5ce4d46e87e79c6b123</citedby><cites>FETCH-LOGICAL-c3594-b45418eb0bc4393b7e7402efdc5d2506e971b712de321b5ce4d46e87e79c6b123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17720714$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16528154$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brisman, Jonathan L.</creatorcontrib><creatorcontrib>Li, Maria</creatorcontrib><creatorcontrib>Hamilton, Dean</creatorcontrib><creatorcontrib>Mayberg, Marc R.</creatorcontrib><creatorcontrib>Newell, David W.</creatorcontrib><title>Cystic Dilation of the Conus Ventriculus Terminalis Presenting as an Acute Cauda Equina Syndrome Relieved by Decompression and Cyst Drainage: Case Report</title><title>Neurosurgery</title><addtitle>Neurosurgery</addtitle><description>OBJECTIVE AND IMPORTANCE:The ventriculus terminalis of the conus, or "fifth ventricle" refers to the ependymal-lined space in the middle of the conus that is present in childhood and whose persistence into adulthood is rare. A number of cases of cystic dilatation of the ventriculus terminalis have been described in adulthood. Patients tend to present with either pain alone or gradually progressive conus or cauda equina syndromes with varying degrees of recovery after cyst drainage. Presentation with an acute cauda equina syndrome and its successful surgical management has not been previously reported.
CLINICAL PRESENTATION:A 57-year-old woman experienced back pain and bilateral sciatica ascribed to diabetic neuropathy for 2 years. Over a 24-hour period she developed bilateral lower extremity weakness, saddle anesthesia, and bowel and bladder incontinence. Lumbosacral magnetic resonance imaging demonstrated a large cystic dilatation of the ventriculus terminalis.
INTERVENTION:She was taken for emergency surgical decompression and cyst drainage. Immediately after surgery, she experienced significant increase in lower extremity strength and has since regained continence.
CONCLUSION:Cystic dilation of the ventriculus terminalis should be part of the differential diagnosis for a cauda equina syndrome; surgical decompression with simple cyst drainage can result in excellent clinical results.</description><subject>Biological and medical sciences</subject><subject>Decompression, Surgical - methods</subject><subject>Diagnosis, Differential</subject><subject>Dilatation, Pathologic - diagnosis</subject><subject>Dilatation, Pathologic - surgery</subject><subject>Drainage - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nerve Compression Syndromes - diagnosis</subject><subject>Nerve Compression Syndromes - surgery</subject><subject>Neurosurgery</subject><subject>Polyradiculopathy - diagnosis</subject><subject>Polyradiculopathy - surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><issn>0148-396X</issn><issn>1524-4040</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkdFqFDEUhgdR7Fp9BQmC3s2YZDJJpndlt1ahoGgV70Imc6YbzSTbZMayj-LbNtNd2MDh5JDvPz_hL4p3BFeEUvERk8rDXOF8SCuY5BVvhCSVlM-KFWkoKxlm-HmxwoTJsm7577PiVUp_Ms6ZkC-LM8IbKknDVsX_9T5N1qCNdXqywaMwoGkLaB38nNAv8FO0Znb5fgtxtF47m9C3CCm_WH-HdELao0szT1mj516jq_s5Y-jH3vcxjIC-g7PwD3rU7dEGTBh3WZ0WK-17tNijTdRZcgcXeUVaFLsQp9fFi0G7BG-O_bz4-enqdv25vPl6_WV9eVOaumlZ2bGGEQkd7gyr27oTIBimMPSm6WmDObSCdILQHmpKusYA6xkHmbHW8I7Q-rz4cNi7i-F-hjSp0SYDzmkPYU6KC1FzwusMXhxAE0NKEQa1i3bUca8IVkswChOVg1GnYNRTMErKLH57dJm7EfqT9JhEBt4fAZ2MdkPU3th04oSgWJCFYwfuIbgJYvrr5geIagvaTdsna54_VdLccZ2nMhdl9SM-Sqj1</recordid><startdate>200603</startdate><enddate>200603</enddate><creator>Brisman, Jonathan L.</creator><creator>Li, Maria</creator><creator>Hamilton, Dean</creator><creator>Mayberg, Marc R.</creator><creator>Newell, David W.</creator><general>Copyright by the Congress of Neurological Surgeons</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200603</creationdate><title>Cystic Dilation of the Conus Ventriculus Terminalis Presenting as an Acute Cauda Equina Syndrome Relieved by Decompression and Cyst Drainage: Case Report</title><author>Brisman, Jonathan L. ; Li, Maria ; Hamilton, Dean ; Mayberg, Marc R. ; Newell, David W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3594-b45418eb0bc4393b7e7402efdc5d2506e971b712de321b5ce4d46e87e79c6b123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Biological and medical sciences</topic><topic>Decompression, Surgical - methods</topic><topic>Diagnosis, Differential</topic><topic>Dilatation, Pathologic - diagnosis</topic><topic>Dilatation, Pathologic - surgery</topic><topic>Drainage - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nerve Compression Syndromes - diagnosis</topic><topic>Nerve Compression Syndromes - surgery</topic><topic>Neurosurgery</topic><topic>Polyradiculopathy - diagnosis</topic><topic>Polyradiculopathy - surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brisman, Jonathan L.</creatorcontrib><creatorcontrib>Li, Maria</creatorcontrib><creatorcontrib>Hamilton, Dean</creatorcontrib><creatorcontrib>Mayberg, Marc R.</creatorcontrib><creatorcontrib>Newell, David W.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brisman, Jonathan L.</au><au>Li, Maria</au><au>Hamilton, Dean</au><au>Mayberg, Marc R.</au><au>Newell, David W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cystic Dilation of the Conus Ventriculus Terminalis Presenting as an Acute Cauda Equina Syndrome Relieved by Decompression and Cyst Drainage: Case Report</atitle><jtitle>Neurosurgery</jtitle><addtitle>Neurosurgery</addtitle><date>2006-03</date><risdate>2006</risdate><volume>58</volume><issue>3</issue><spage>E585</spage><epage>E585</epage><pages>E585-E585</pages><issn>0148-396X</issn><eissn>1524-4040</eissn><coden>NRSRDY</coden><abstract>OBJECTIVE AND IMPORTANCE:The ventriculus terminalis of the conus, or "fifth ventricle" refers to the ependymal-lined space in the middle of the conus that is present in childhood and whose persistence into adulthood is rare. A number of cases of cystic dilatation of the ventriculus terminalis have been described in adulthood. Patients tend to present with either pain alone or gradually progressive conus or cauda equina syndromes with varying degrees of recovery after cyst drainage. Presentation with an acute cauda equina syndrome and its successful surgical management has not been previously reported.
CLINICAL PRESENTATION:A 57-year-old woman experienced back pain and bilateral sciatica ascribed to diabetic neuropathy for 2 years. Over a 24-hour period she developed bilateral lower extremity weakness, saddle anesthesia, and bowel and bladder incontinence. Lumbosacral magnetic resonance imaging demonstrated a large cystic dilatation of the ventriculus terminalis.
INTERVENTION:She was taken for emergency surgical decompression and cyst drainage. Immediately after surgery, she experienced significant increase in lower extremity strength and has since regained continence.
CONCLUSION:Cystic dilation of the ventriculus terminalis should be part of the differential diagnosis for a cauda equina syndrome; surgical decompression with simple cyst drainage can result in excellent clinical results.</abstract><cop>Hagerstown, MD</cop><pub>Copyright by the Congress of Neurological Surgeons</pub><pmid>16528154</pmid><doi>10.1227/01.neu.0000197486.65781.88</doi><tpages>2</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Biological and medical sciences Decompression, Surgical - methods Diagnosis, Differential Dilatation, Pathologic - diagnosis Dilatation, Pathologic - surgery Drainage - methods Female Humans Medical sciences Middle Aged Nerve Compression Syndromes - diagnosis Nerve Compression Syndromes - surgery Neurosurgery Polyradiculopathy - diagnosis Polyradiculopathy - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases |
title | Cystic Dilation of the Conus Ventriculus Terminalis Presenting as an Acute Cauda Equina Syndrome Relieved by Decompression and Cyst Drainage: Case Report |
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