OBJECTIVE: Blake's pouch cyst (BPC) is a midline cystic malformation of the posterior fossa, within Dandy-Walker's complex (DWC), often associated with hydrocephalus. Endoscopic third ventriculostomy (ETV) has been an alternative to conventional methods for BPC treatment. This study aimed at reporting our experience with ETV in a series of patients with BPC. METHODS: Of 33 patients diagnosed with midline posterior fossa cyst, 26 met the protocol criteria for DWC, and eight subjects with BPC were selected (aged one month to two years old). All cases were treated with ETV. RESULTS: Five patients were male; and three were prenatally diagnosed. They had hydrocephalus and motor deficiencies. Motor assessment at a five-year follow-up yielded normal findings. All patients improved, and only one had residual cognitive dysfunction, despite overall neurological improvement. There were no complications. CONCLUSIONS: ETV was a safe and effective procedure, reducing risks and morbidity associated with open surgery and shunt-related problems.
Meningiomas in children account for less than 2% of all meningiomas, and their location in the spinal region is even less common. The authors present a case of a 20-month-old female who presented with lumbar back pain, neurogenic bladder and progressive paraparesis 6 months after she started to walk. Magnetic resonance imaging demonstrated an intradural extramedullary neoplasm extending from the tenth thoracic vertebra to the third lumbar vertebra. Complete excision of the tumor was performed by means of laminoplasty and the patient had a satisfactory postoperative recovery. Pathology and immunohistochemical studies diagnosed psammomatous meningioma.
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