Endoscopically-assisted resection of a choroid plexus vascular malformation traversing the cerebral aqueduct: technical case report.

Abstract

We report a case of a choroid plexus vascular malformation of the cerebral aqueduct, third, and fourth ventricles of an adolescent female that was resected with endoscopic assistance. A 14-year-old girl presented with a 1-week history of headaches and emesis. A noncontrasted computed tomographic scan of the head demonstrated enlarged lateral and third ventricles. Subsequent magnetic resonance imaging scans with and without contrast revealed an enhancing mass originating in the third ventricle, traversing the cerebral aqueduct, and terminating in the fourth ventricle. We used a suboccipital approach to remove the vascular malformation after endoscopically disconnecting it from its feeding and draining vessels in the third ventricle. Total excision was performed. Postoperative magnetic resonance imaging scans and arteriograms confirmed complete resection of the vascular malformation. Choroid plexus vascular malformations can exist intraventricularly and can be confused with a neoplasm. Resection of these intraventricular lesions can be performed with endoscopic assistance.