Dilation of the ventriculus terminalis: sonographic findings.

Abstract

A newborn term male infant was found to have the stigmata of VACTERL syndrome, including cervical and thoracic hemivertebra, partial sacral agenesis, 13 pairs of ribs, high imperforate anus with rectovesical fistula, and tracheoesophageal fistula with proximal esophageal atresia. No open spinal dysraphism or skin dimpling was seen. Ultrasonography of the spinal cord was performed to screen for occult anomalies. The examination revealed a lipoma of the filum terminalis and a low‐lying conus medullaris at the L3‐L4 level with a large central cystic structure in the terminal cord, which was continuous with the central canal (Fig. 1). This was thought to most likely represent a dilated ventriculus terminalis, and the diagnosis was confirmed on a subsequent MR image (Fig. 2). Fluid in the cyst followed cerebrospinal fluid signal in all sequences. We observed no abnormal signal in the adjacent parenchyma or enhancement associated with the cystic mass. A cranial ultrasonogram did not reveal any intracranial anomalies. The patient demonstrated no neurologic deficits in the lower extremities. Bowel and urinary continence was not assessable in this infant.

The cystic dilation of ventriculus terminalis with neurological symptoms: Three case reports and a literature review

“…7 The origin of the VT can be traced to the embryonic development of the spinal cord, which can be subdivided into two stages: neurulation and canalization or retrogressive differentiation. 8 Neurulation starts when the embryo is three-weeks old, and it is responsible for the formation of the neural tube through the progressive closure of the neural plate and its separation from the overlying ectoderm. The distal cord develops from a caudal cell mass that forms from the neuralepithelium and a notochord caudal to the primary neural tube.…”

“…7 The VT appears after approximately 45 days (between the 43 rd and the 48 th day) after conception. 8 The presence of a fifth ventricle has been described in literature as a normal developmental phenomenon, especially in newborns and infants. 8 The longitudinal diameter of the terminal ventricle is 8-10 mm, and its transverse diameter is 2-4 mm.…”

Development of the Fetal Spinal Cord

“…Truong et al 16 ine the SC of the fetus in utero, normal anatomy and anomalies could be easily detected. Prenatal diagnosis of spina bifida aperta by sonography is well established.…”

Enlarging Ventriculus Terminalis in a Patient With Polyarteritis Nodosa

“…The ventriculus terminalis (VT) or "fifth ventricle" is a small ependymal-lined residual lumen in continuity with the central canal of the conus medullaris. VT is normally present in all humans during fetal development and typically regresses completely after birth [1][2][3]. Its persistence into adulthood represents a rare pathology [4].…”