title: Third ventricular ependymal cyst presenting with acute hydrocephalus.
abstract: Ependymal cysts are generally located in the cerebral parenchyma but rarely found in the third ventricle. A 4-year-old boy presented with headache, vomiting, and upward gaze palsy. His consciousness gradually deteriorated in the course of 6 h. A magnetic resonance imaging study disclosed dilation of the lateral ventricle and a cystic mass in the third ventricle. We performed an endoscopic resection of the cyst wall. The cyst originated on the lateral wall of the third ventricle and obstructed the aqueduct. Histological examination confirmed a diagnosis of ependymal cyst. The patient recovered quickly and his headache and nausea disappeared. Third ventricular ependymal cysts are a rare cause of acute hydrocephalus but an important differential diagnosis. Their neuroendoscopic resection can resolve disturbances in cerebrospinal fluid circulation, is useful for cyst wall removal, and appears to be superior to shunt placement.
authors.affiliation: Department of Neurosurgery, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University Graduate School, Kumamoto, Japan. yanos@kaiju.medic.kumamato-u.ac.jp
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yano
authors.forename: Jun-ichiro
authors.initials: J
authors.lastname: Kuroda
authors.forename: Keishi
authors.initials: K
authors.lastname: Makino
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Tsuiki
authors.forename: Motohiro
authors.initials: M
authors.lastname: Morioka
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kuratsu
mesh_terms: D000208:Acute Disease; D020863:Central Nervous System Cysts / Q000175:diagnosis* / Q000601:surgery; D002675:Child, Preschool; D004724:Endoscopy; D004805:Ependyma / Q000601:surgery*; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D020542:Third Ventricle / Q000601:surgery*