IS Case 299: Ventriculus terminalis

Ahmed El-Sherief, MD

---

Imaging Sciences URMC 2009
Publication Date: 2009-08-05

History

Patient is a 12-month-old male with right leg weakness and sacral dimple on physical exam.

Findings

Ovoid cystic dilatation of the distal central spinal cord between the conus medullaris tip and filum terminale origin.

Diagnosis

Ventriculus terminalis

Discussion

Pathology (microanatomy):

• Mild ovoid cystic (ependymal lined) dilatation of distal central spinal cord canal
• Represents point of union between the portion of the central canal may by neuralation and portion made by canalization of the caudal cell mass
• Usually disappears during 1st six months after birth

Location: between conus medullaris tip and filum terminale origin

• Size: 2-4mm transverse, usually
• < 2cm in length

Imaging Findings (macroanatomy):

• CECT: cord expansion, non-enhancing IM cavity between CMT and FTO
• MR: (between CMT and FTO; CSF intensity signal characteristics)
• T1W: hypointense IM cavity
• T2W: hyperintense IM cavity - T1+C: non-enhancing IM cavity

Clinical symptoms:

• Usually asymptomatic (likely to be identified in 2.6% of children without spinal disease)

Associated abnormalities: Occasionally identified with:

• caudal regression
• tethered cord

References

1. Bowen B , Rivera A , Saraf-Lavi E. Spine Imaging: Case Review Series. 2nd ed., Mosby, 2008.
2. Ross JS, Brant-Zawadski M, Moore K, et al. Diagnostic Imaging: Spine. Amirsys, 2004.