Treatment Strategies for Unknown Anatomic Pathology Ventriculus Terminalis Case Series: Single Center Experience

Yıl 2024, , 237 - 241, 08.10.2024

Ali İmran Özmarasalı , Fakhraddin Yagubov , Pınar Eser Ocak , Şeref Doğan

https://doi.org/10.32708/uutfd.1501644

Öz

The ventriculus terminalis is a cavity in the conus medullaris, bounded by ependymal cells, associated with the central canal. It is an anatomical structure that is very rare in adults, with a limited number of surgical cases that have been reported in the literature. In children, it is regarded as a normal congenital variation, known to regress before five years of age, and very few symptomatic cases have been reported in both pediatric and adult populations. It is often asymptomatic in adults and is detected incidentally. Although potentially nonsignificant individually, symptoms can range from nonspecific low back pain to sphincter dysfunction and focal neurologic deficits. Our purpose is to discuss our management strategy in comparison to the existing literature. A retrospective review was conducted of all adult patients (aged 17 years and older) diagnosed with ventriculus terminalis who were referred to the hospital between 2010 and 2020. Clinical classification was made according to the classification defined by Batista. In addition, Ganau's classification was also used. Five patients were included in the study. The majority of these patients (n=4, 80%) were symptomatic at the time of diagnosis, with nonspecific back pain being the most common symptom (n=3, (60%). None of the patients required neurosurgical intervention during the follow-up period of 21.6±8.9 months, as there was no clinical deterioration observed. Ventriculus terminalis is a rare pathology that may develop de novo in adults, often remaining undiagnosed until the cyst enlarges, and can manifest with a wide spectrum of symptoms. When identified, it requires careful management, involving surgery when necessary and a conservative approach when appropriate.

Anahtar Kelimeler

Ventriculus terminalis, cauda equina, fifth ventricle, spinal cord

Bilinmeyen Anatomik Patoloji Terminal Ventrikül Tedavi Stratejileri: Tek Merkez Deneyimi

Öz

Terminal ventrikül, konus medullariste bulunan, ependimal hücrelerle sınırlanan, santral kanalla ilişkili bir boşluktur. Literatürde sınırlı sayıda cerrahi yapılan olgu bildirilen, erişkinlerde oldukça nadir görülen bir anatomik yapıdır. Çocuklarda, beş yaşından önce gerilediği bilinen normal bir konjenital varyasyon olarak kabul edilmektedir ve hem pediatrik hem de yetişkin popülasyonda çok az sayıda semptomatik vaka rapor edilmiştir. Yetişkinlerde sıklıkla asemptomatiktir ve tesadüfen tespit edilir. Semptomlar nonspesifik bel ağrısından sfinkter fonksiyon bozukluğuna ve fokal nörolojik defisitlere kadar değişebilir. Amacımız nadir görülen bu patolojideki yönetim stratejimizi mevcut literatürle karşılaştırmalı olarak tartışmaktır. 2010-2020 yılları arasında hastaneye başvuran terminal ventrikül tanısı alan tüm erişkin hastalar (17 yaş ve üzeri) retrospektif olarak incelendi. Klinik sınıflandırma Batista'nın tanımladığı sınıflamaya göre yapıldı. Ayrıca Ganau'nun sınıflandırması da kullanıldı. Çalışmaya 5 hasta dahil edildi. Bu hastaların çoğunluğu (n=4, %80) tanı anında semptomatik olup, en sık görülen semptom nonspesifik sırt ağrısıydı (n=3, (%60). Hiçbir hastanın kliniğinde kötüleşme olmadı, takip süresi 21,6±8,9 aydı. Terminal ventrikül erişkinlerde de novo olarak gelişebilen, sıklıkla kist büyüyene kadar tanı konulamayan ve geniş bir semptom yelpazesiyle ortaya çıkabilen nadir bir patolojidir. Saptandığında, gerektiğinde cerrahiyi ve uygun olduğunda konservatif bir yaklaşımı içeren dikkatli bir tedavi gerektirir.

Anahtar Kelimeler

Terminal ventrikül, kauda equina, beşinci ventrikül, spinal kord

Kaynakça

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