ABSTRACT
BACKGROUND: Cavum septum pellucidum (CSP) cysts are rare lesions which are frequently asymptomatic. Some clinical findings may be associated with CSP cysts, such as headache and other symptoms of increased intracranial pressure, neurological deficit, and mental status changes. There is still controversy in the management of symptomatic cases, especially in children. The main difficulty is to establish a correlation between symptoms and the cyst. When indicated, the treatment is essentially surgical, and the ideal operative technique is also a matter of debate. CASE REPORT: We present a case of a 14-year-old boy with a symptomatic CSP cyst who was successfully treated by neuronavigation-assisted neuroendoscopy with a bilateral fenestration. A literature review is provided with regard to clinical presentation, treatment, and outcome in children. CONCLUSION: The treatment is considered whenever there is an association of a CSP cyst on imaging studies and symptoms attributable to the obstruction of the cerebrospinal fluid flow or direct compression of surrounding structures by the cyst. Endoscopic fenestration is a less invasive and highly effective technique, and is currently the treatment of choice for such lesions in children.
Subject(s)
Brain Neoplasms/pathology , Central Nervous System Cysts/pathology , Neuroendoscopy/methods , Septum Pellucidum/pathology , Adolescent , Brain Neoplasms/surgery , Central Nervous System Cysts/surgery , Humans , Male , Neuronavigation , Septum Pellucidum/surgeryABSTRACT
We report the case of a 60-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) that presented with headache and right complete ophthalmoplegia. The CT scan raised the possibility of a giant aneurysm of the right intracavernous internal carotid artery, confirmed by angiography. The patient underwent endovascular occlusion of parent vessel with detachable coils, then she presented interruption of headache and partial recovery of ptosis and ophthalmoplegia. We emphasize the relationship between ADPKD and intracranial aneurysms. We also discuss the natural history and compare the therapeutic options for the management of giant aneurysms of the cavernous portion of the carotid artery.
Subject(s)
Carotid Artery Diseases/complications , Carotid Artery, Internal , Intracranial Aneurysm/complications , Polycystic Kidney, Autosomal Dominant/complications , Balloon Occlusion , Carotid Artery Diseases/diagnosis , Carotid Artery Diseases/surgery , Cerebral Angiography , Female , Humans , Intracranial Aneurysm/diagnosis , Intracranial Aneurysm/surgery , Middle AgedABSTRACT
Apresenta-se o caso de mulher de 60 anos com doença renal policística autossômica dominante (DRPAD) que desenvolveu quadro de cefaléia e oftalmoplegia completa à direita. A TC levantou a hipótese de um aneurisma gigante do segmento intracavernoso da carótida interna direita, o que foi confirmado pela arteriografia. Realizou-se, então, tratamento endovascular por oclusão do vaso parental com molas destacáveis no segmento supraclinóideo. A paciente evoluiu com a interrupção da cefaléia e com redução parcial da ptose e da oftalmoplegia. Neste artigo, enfatiza-se a relação entre DRPAD e aneurismas intracranianos. Comenta-se a história natural dos aneurismas originados no segmento intracavernoso da artéria carótida interna e comparam-se as opções terapêuticas no manejo destas lesões.
We report the case of a 60 years-old woman with autosomal dominant polycystic kidney disease (ADPKD) that presented with headache and right complete ophthalmoplegia. The CT scan raised the possibility of a giant aneurysm of the right intracavernous internal carotid artery, confirmed by angiography. The patient underwent endovascular occlusion of parent vessel with detachable coils, then she presented interruption of headache and partial recovery of ptosis and ophthalmoplegia. We emphasize the relationship between ADPKD and intracranial aneurysms. We also discuss the natural history and compare the therapeutic options for the management of giant aneurysms of the cavernous portion of the carotid artery.
