REVIEW

Symptomatic Pediatric Ventriculus Terminalis, a Rare Ependymal-Lined Cavity of the Conus Medullaris: literature review

Ventriculus Terminalis Sintomático em Paciente Pediátrico uma Rara Cavidade do Cone Medular Revestida por Células Ependimárias: revisão de literatura

  • Lorimer Sandoval Carneiro (1)
  • Lissa Carrilho Goulart (1)
  • Tiago Vinicius Silva Fernandes (1)
  • Caio Rodrigues Gomes Dias (2)
  • Julia Jordana Freitas Lima (2)
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Resumo

Introdução: O quinto ventrículo, também conhecido como ventriculus terminalis, é um termo usado para descrever uma cavidade cística revestida pelo epêndima do cone medular. Sua persistência é uma entidade rara na idade adulta e, na infância, o ventriculus terminalis geralmente não persiste por mais de 5 anos de idade. Métodos: A revisão da literatura foi realizada em 2021 nas bases de dados Medline (PubMed) e Lilacs (via BVS), do período posterior a 1991. Selecionamos os artigos que apresentavam casos de ventriculus terminalis em uma população maior de 5 anos de idade, principalmente na faixa etária pediátrica, diagnosticados por ultrassonografia ou ressonância magnética da coluna dorsal e lombar. Relato do Caso: Paciente de 9 anos com episódios de paresia e disfunção urinária devido ao ventriculus terminalis localizado ao nível de T11-T12, submetido a laminectomia e fenestração cirúrgica da dilatação, com boa evolução neurológica. No pós-operatório, o paciente apresentou fístula liquórica, a qual foi corrigida cirurgicamente. Conclusão: Uma revisão atualizada da literatura no intuito de chamar a atenção para um caso raro de ventrículo terminal sintomático e enfatizar a importância da inclusão do quinto ventrículo no diagnóstico diferencial das lesões medulares, para garantir o mais adequado tratamento.

Palavras-chave

Fenestração cística; Lesões do cone medular; Quinto ventrículo; Ventriculus terminalis

Abstract

Introduction: The fifth ventricle, also known as ventriculus terminalis, is a term used to describe a cystic ependymal-lined cavity of the conus medullaris. Its persistence is a rare entity into adulthood and, in childhood, the ventriculus terminalis usually does not persist for more than 5 years of age. Methods: The literature review was performed in 2021 in the Medline (PubMed) and Lilacs (via BVS) databases, from the period after 1991. Articles that presented new cases of ventriculus terminalis in a population older than 5 years old, especially in the pediatric age group, diagnosed by ultrasound or MR of the dorsal and lumbar spine. Case Presentation: Male patient, 9-year-old, presenting episodes of paresis and bladder dysfunction due to a fifth ventricle at the level of T11-T12. Surgery was performed with good neurological outcome. Postoperatively, the patient presented CSF leak, which was corrected, surgically. Conclusion: An updated literature review is presented aiming to draw attention to a rare case of symptomatic ventriculus terminalis and to emphasize the importance of including the fifth ventricle in differential diagnosis of the spinal cord lesions to ensure proper treatment.

Keywords

Cyst fenestration; Conus medullaris lesions; Fifth ventricle; Ventriculus terminalis

References

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1 MD, Division of Neurosurgery, Department of Surgery, Medical School, Federal University of Goiás, Goiânia, GO, Brazil.

2 Student of Medicine, Federal University of Goiás, Goiânia, GO, Brazil.

 

Received Apr 5, 2022
Accepted Oct 4, 2022

JBNC  Brazilian Journal of Neurosurgery

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