Benign cyst of the paramedian pontine tegmentum.
A benign ovoid cyst, without an epithelial lining, localized in the paramedian pontine tegmentum, was examined by computed tomography (CT) and magnetic resonance imaging (MRI) (25 x 15 x 15 mm) and successfully operated upon. The one-and-a-half syndrome (horizontal gaze palsy to the right and paralysis of adduction of the right eye) and ipsilateral "peripheral" VII nerve palsy dominated the clinical picture. Fenestration, 5 mm in diameter, of the cyst wall through the floor of the IV ventricle was performed and 2.6 ml of clear, colorless fluid was evacuated. Inspection of the cyst, using the operating microscope, revealed a smooth, white, glistening cavity with no evidence of other pathological tissue. Duraplasty was performed with allogenic pericardium. Neurological symptoms improved immediately after surgery. Light and electron microscopy of the cyst wall revealed a fibrillar astroglial network and fragments of ependyma at the ventricular side of the biopsy.
Parízek
J
J
Department of Neurosurgery, Medical Faculty Charles University, Hradec Králové, Czechoslovakia.
Nĕmecek
S
S
Spacek
J
J
Nĕmecková
J
J
Lízler
J
J
Sercl
M
M
Vokurka
J
J
Mĕricka
P
P
Vanásková
Z
Z
D000293:Adolescent; D001927:Brain Diseases / Q000175:diagnosis / Q000601:surgery; D003560:Cysts / Q000175:diagnosis / Q000601:surgery* / Q000648:ultrastructure; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008854:Microscopy, Electron; D011149:Pons; D014057:Tomography, X-Ray Computed