4th ventricle cysts and abnormal gait

[globalmom]

What are possible causes and implications of 4th ventricle cysts, and how would they cause a gait abnormality? Could they be papillomas? My late husband had inverting papillomas in his sinuses.

[Joanna Fong, MD]

I am happy to answer your questions.  However, my impression is based entirely on the information you have provided in your posting and is by no means a replacement for an office visit with a neurologist.  Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.

Cysts in the ventricular system are mostly benign.  They can be congenital or acquired.  There are several types of cysts found in the ventricular system, e.g. colloid, arachnoid, and ependymal cyst.  However, it can sometimes cause hydrocephalus (enlargement of the ventricle) when the cyst obstructs the flow of the cerebral spinal fluid.  MRI or CT can easily pick up hydrocephalus.  

Several signs/symptoms that are suggestive of hydrocephalus:
1)  Headache
2)  Nausea, vomiting
3)  Decrease level of consciousness
4)  Visual changes (double vision, blurry vision)
5)  Gait abnormality

Ways that a cyst can cause gait abnormality:

1)  Epidermoid cysts (especially in young adults) are usually found in the cerebellopontine angle or skull.  This area is adjacent to an area of the brain call cerebellum.  Cerebellum controls our gait/balance.  If the cyst is compressing onto cerebellum, you can see gait disturbances.
2)  Hydrocephalus itself can cause gait abnormality.  Mechanism of it is still unknown.  The gait abnormality is typically called "gait apraxia".

I don't think they're papillomas.  

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Good luck.