Rare Third Ventricular Cysts Mimicking Neurological Diseases: A Case-series

To report four cases of third ventricular cysts with unusual clinical presentations and discuss their potential classification as a novel syndrome. Patients with incidentally identified third ventricular cysts who underwent surgical resection were described. Their clinical presentations, neuroimaging findings, and surgical outcomes were analyzed. All four patients presented with acute-onset neurological symptoms, including gait disturbances, mentation disorders, and urinary dysfunction, similar to normal pressure hydrocephalus, but with a third ventricular cyst. Additionally, their symptoms rapidly resolved following surgical resection of the cysts. The cysts differed from existing diagnoses in their location, signal characteristics on MRI, and the presence of a unique "white wall" and a novel aqueduct. These cases are characterized by the presence of third ventricular cysts with distinct neuroimaging features and a unique clinical presentation of rapidly progressive neurological symptoms that improve dramatically after neuroendoscopic surgery. Further research is needed to validate this condition and elucidate its pathophysiology.