Epidermoid cyst of the fourth ventricle.
The case of a 52-year-old patient with a fourth ventricle epidermoid is reported. The initial presentation included long-standing headaches, progressive anomalies of gait and slight impairment of mentation. CT showed a hypodense mass enhancing peripherally after contrast infusion. Brain auditory evoked responses (BAER) showed asymmetric increased latencies. At operation, total removal of an extensive fourth ventricle epidermoid was achieved. A delayed meningitis occurred postoperatively. Physical examination was normal at the 2 year follow-up and BAER were improved. The etiological and clinical features of fourth ventricular epidermoids are briefly reviewed. The diagnostic value of CT is emphasised but the possibility of CT-dense epidermoid cysts deserves a special mention. Total removal of the neoplasm is the theoretical aim of operative treatment, but this purpose may be harmful when the ventricular floor is involved by the capsule.
Bret
P
P
Service de Neurochirurgie C. Hôpital Neurologique et Neurochirurgical Pierre Wertheimer 59, Lyon, France.
Remond
J
J
Fischer
C
C
Fischer
G
G
Kzaiz
M
M
D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D002552:Cerebral Ventricles / Q000473:pathology*; D004814:Epidermal Cyst / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography