Non-neoplastic gliotic cerebellar cysts: clinical and computed tomographic correlations

Posterior fossa giant tumefactive perivascular spaces: 8-year follow-up in an adolescent

Background:

Cystic masses in the posterior fossa are ominous appearing lesions with broad differential diagnosis. Giant tumefactive perivascular spaces (GTPS) are rarely occurring pathological findings in the posterior fossa with unclear etiology and ill-defined long-term prognosis.

Case Description:

We present a case of a 15-year-old male diagnosed with posterior fossa GTPS. The patient remained asymptomatic during the 8-year follow-up after diagnosis with the serial magnetic resonance imaging (MRI) showing no change in the size and morphology of the lesion.

Conclusion:

This case supports prior literature on supratentorial GTPS suggesting that the natural history of GTPS is mostly benign. Identification of GTPS in the posterior fossa could prevent the patient from unnecessary surgery or other aggressive treatment modalities.

[Intramedullary neuroglial cyst: a case report]

BACKGROUND AND PURPOSE

Neuroglial cysts are uncommon congenital lesion with own wall, which can be confined into or outside the central nervous system. In the central nervous system the cyst is located commonly in the brain. Spinal intramedullary neuroglial cyst are exceptional. Our objective is to present a case of intramedullary neuroglial cyst, to discuss the differentiels diagnosis and to show difficulties of its medical taking care.

CASE REPORT

A 60 year-old man, without past history, was admitted to the hospital with a compression of conus medullaris since one year. The clinical examination revealed paraparesis and genito-sphincterian disorders. MRI of the spine revealed intramedullary cyst at T12-L1 level. The patient underwent cystic evacuation, a large marsupialization of the cavity and a wall biopsy. Histopathological examination confirmed the diagnosis of neuroglial cyst. The postoperative outcome was favourable with a partial improvement of motor weakness. Postoperative MRI showed a persistent residual cavity.

CONCLUSION

Neuroglial intramedullary cyst is uncommon. It is a benign lesion. Complete surgical resection is very difficult seen the absence of defined plan cleavage.

Symptomatic glial cysts of the pineal gland

Two cases of symptomatic glial cysts of the pineal gland are reported. An origin similar to that proposed for paraventricular glial cysts of the brain is accepted. These unusual lesions could be considered in the differential diagnosis of cystic pineal masses.

Benign intraparenchymal brain cysts without an epithelial lining

Three patients are presented who had benign intraparenchymal cysts of the brain. The wall of each cyst was biopsied and had no epithelial lining or other microscopic feature to indicate the etiology of the cyst. The authors review published information about benign brain cysts and speculate about the origin of those having a wall composed solely of neuroglial tissue.

Cavum vergae cyst as a cause of hydrocephalus, "almost forgotten"? Successful stereotactic treatment

Cavum vergae cysts (CVC) are cerebral midline malformations, which usually have no clinical manifestations. In rare cases, however, non-communicating cysts can cause hydrocephalus by obstruction of the aqueduct. Initially, from 1930 to 1960 operative treatment consisted in open cysto-ventriculostomy, i.e. establishing a communication between CVC and the ventricles, via a transventricular approach. In the era of CT, symptomatic treatment of the hydrocephalus by ventriculo-atrial or ventriculo-peritoneal shunts is preferred. All the wellknown complications of shunting are encountered. Based on the experience of our cases of CVC with clinical manifestations, we here propose a definitive causal treatment which can be achieved by draining the cyst contents into the ventricles via a stereotactically introduced catheter.