Burr hole monoportal endoscopic resection of a large choroid plexus cyst causing obstructive hydrocephalus: diagnosis, management and literature review

Introduction Choroid plexus cysts, the most common neuroepithelial cystic lesions, are rarely symptomatic and often discovered incidentally. Materials and methods We report our experience of managing a 22-year-old man who presented with a short history of severe, progressive headache secondary to hydrocephalus as a result of obstruction at the level of the foramina of Monro. Results High resolution MRI sequences demonstrated a large cystic lesion filling and expanding the foramina of Monro and extending into the third ventricle. Endoscopic gross total resection of the cyst and a septum pellucidotomy were performed through a monoportal approach with resolution of the hydrocephalus and the headaches. Conclusion Although symptomatic choroid plexus cysts are rare, they should be considered in the differential diagnosis of intraventricular lesions causing obstructive hydrocephalus and appropriate imaging performed. Endoscopic resection is a safe and definitive intervention, which allows complete excision via a minimally invasive approach.