Cyst of the medullary conus: malformative persistence of terminal ventricle or compressive dilatation?
The ventriculus terminalis is a cavity situated at the level of the conus medullaris, enclosed by ependymal tissue and normally present as a virtual cavity or as a mere ependymal residue. In rare cases, and almost exclusively in pediatric age, the ventriculus terminalis may be visualized by radiological investigations, either by sonography or MRI, and represents a transient finding in children under 5 years of age. In pathological conditions, a cyst of the conus medullaris is probably the result of a persistent ventriculus terminalis and is usually described in children in association with a tethered cord; in a very limited number of cases, it has been described in adults whose clinical symptoms consist of neurological and/or sphincter disturbances not associated with other pathologies. The authors describe the case of a 42-year-old female with a cyst of the conus whose only symptom was imperious minction; she had been suffering from these urinary disorders for many years. The patient was not operated on because the clinical situation remained stable, without modifications of the MRI in follow-up over a 6-year period. The authors therefore suggest that in adult patients, a cyst of the conus medullaris is probably an expression of malformative persistence of the fifth ventricle and does not necessarily have a progressive evolution.
Celli
Paolo
P
Second Faculty of Medicine, Department of Neurological Sciences, University of Rome La Sapienza, Italy.
D'Andrea
Giancarlo
G
Trillò
Giuseppe
G
Roperto
Raffaelino
R
Acqui
Michele
M
Ferrante
Luigi
L
D000328:Adult; D002552:Cerebral Ventricles / Q000002:abnormalities; D003560:Cysts / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology