TREATMENT OPTIONS FOR THIRD VENTRICULAR COLLOID CYSTS

Neurosurgery ◽  
2007 ◽  
Vol 60 (4) ◽  
pp. 613-620 ◽  
Author(s):  
Eric M. Horn ◽  
Iman Feiz-Erfan ◽  
Ruth E. Bristol ◽  
Gregory P. Lekovic ◽  
Pamela W. Goslar ◽  
...  
Keyword(s):  
Third Ventricle ◽  
Treatment Options ◽  
Operating Time ◽  
Colloid Cyst ◽  
First Line ◽  
Transcallosal Approach ◽  
Neurological Outcomes ◽  
Colloid Cysts ◽  
Endoscopic Group

Abstract OBJECTIVE We retrospectively reviewed our experience treating third ventricular colloid cysts to compare the efficacy of endoscopic and transcallosal approaches. METHODS Between September 1994 and March 2004, 55 patients underwent third ventricular colloid cyst resection. The transcallosal approach was used in 27 patients; the endoscopic approach was used in 28 patients. Age, sex, cyst diameter, and presence of hydrocephalus were similar between the two groups. RESULTS The operating time and hospital stay were significantly longer in the transcallosal craniotomy group compared with the endoscopic group. Both approaches led to reoperations in three patients. The endoscopic group had two subsequent craniotomies for residual cysts and one repeat endoscopic procedure because of equipment malfunction. The transcallosal craniotomy group had two reoperations for fractured drainage catheters and one operation for epidural hematoma evacuation. The transcallosal craniotomy group had a higher rate of patients requiring a ventriculoperitoneal shunt (five versus two) and a higher infection rate (five versus none). Intermediate follow-up demonstrated more small residual cysts in the endoscopic group than in the transcallosal craniotomy group (seven versus one). Overall neurological outcomes, however, were similar in the two groups. CONCLUSION Compared with transcallosal craniotomy, neuroendoscopy is a safe and effective approach for removal of colloid cysts in the third ventricle. The endoscope can be considered a first-line treatment for these lesions, with the understanding that a small number of these patients may need an open craniotomy to remove residual cysts.

Purely Endoscopic Resection of Colloid Cysts

2008 ◽  
Vol 62 (suppl_1) ◽  
pp. ONS51-ONS56 ◽  
Author(s):  
Jeremy D.W. Greenlee ◽  
Charles Teo ◽  
Ali Ghahreman ◽  
Bernard Kwok
Keyword(s):  
Endoscopic Resection ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Foramen Of Monro ◽  
The Third ◽  
Colloid Cysts ◽  
Study Support

Abstract Objective: To further assess the safety and long-term efficacy of endoscopic resection of colloid cysts of the third ventricle. Methods: A retrospective review of a series of 35 consecutive patients (18 male, 17 female) with colloid cysts treated by endoscopic surgery was undertaken. Results: The mean patient age was 32.4 years (range, 11–54 yr). Headache was the most common presenting symptom (22 patients). The average tumor size was 18 mm (range, 3–50 mm). The endoscopic technique could not be completed in six patients, necessitating conversion to an open craniotomy and a transcortical approach to the colloid cyst. All patients had histologically confirmed colloid cysts of the third ventricle, and complete resection of the lesion was confirmed macroscopically and radiologically in all patients. There were no deaths. Two patients developed aseptic meningitis without any permanent sequelae. One patient developed unilateral hydrocephalus attributable to obstruction of the foramen of Monro, which was treated with endoscopic septum pellucidotomy. The median follow-up period was 88 months (range, 10–132 mo). There was one asymptomatic radiological recurrence. No seizures occurred after surgery. Conclusion: The results of this study support the role of endoscopic resection in the treatment of patients with colloid cysts as a safe and effective modality. In some cases, conversion to an open procedure may be required. Additional follow-up will be required to continue to address the duration of lesion-free survival.

DIZYGOTIC TWINS WITH A COLLOID CYST OF THE THIRD VENTRICLE

Neurosurgery ◽  
2008 ◽  
Vol 63 (5) ◽  
pp. E1003-E1003 ◽  
Author(s):  
Rossana Romani ◽  
Mika Niemelä ◽  
Miikka Korja ◽  
Juha A. Hernesniemi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Resonance Imaging ◽  
Transcallosal Approach ◽  
The Third ◽  
Familial Cases ◽  
Colloid Cysts

Abstract OBJECTIVE AND IMPORTANCE Colloid cysts of the third ventricle are rare benign tumors of endodermal origin accounting for 1% of all intracranial tumors. Interestingly, a few familial cases have been reported previously. We present the first case of dizygotic twins with a symptomatic colloid cyst of the third ventricle. CLINICAL PRESENTATION A 10-year-old boy was admitted to a local hospital in 1993 because of severe progressive headache. Computed tomographic and magnetic resonance imaging scans revealed acute obstructive hydrocephalus attributable to a third ventricular colloid cyst, which was removed after emergent ventricular drainage. Fourteen years later, a nonidentical twin brother complained of continuous headache with nausea and vomiting. A magnetic resonance imaging scan showed obstructive hydrocephalus and a third ventricle colloid cyst, which was removed by use of the transcallosal approach. INTERVENTION Both twins underwent complete removal of the cyst by the interhemispheric transcallosal approach without postoperative complications. CONCLUSION On the basis of a literature review, 2 cases of colloid cysts of the third ventricle in monozygotic twins and a few familial cases have been reported. Our case is the first in dizygotic twin brothers. These findings suggest that the prevalence of colloid cyst may be higher in twins than in the general population. We believe that the presence of this lesion in a twin necessitates magnetic resonance imaging of the other twin, and a clinical follow-up would be recommended in all other first-degree relatives.

Third ventricle colloid cysts: a consecutive 12-year series

1997 ◽  
Vol 86 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Tiit Mathiesen ◽  
Per Grane ◽  
Lars Lindgren ◽  
Christer Lindquist
Keyword(s):  
Third Ventricle ◽  
Colloid Cyst ◽  
Memory Deficit ◽  
Individual Treatment ◽  
Content Type ◽  
Colloid Cysts ◽  
Permanent Morbidity ◽  
Radiological Studies ◽  
Fine Print

✓ A continuous follow-up review of colloid cysts including aspects of natural history and evaluation of treatment options is necessary to optimize individual treatment. Thirty-seven consecutive patients with colloid cyst of the third ventricle seen at Karolinska Hospital between 1984 and 1995 were reviewed. Five patients were admitted in a comatose state, and two died despite emergency ventriculostomy. Three had recurrent cysts following previous aspiration procedure. During the study period, patients underwent a total of 10 ventriculostomies, 10 aspirations, 26 microsurgical operations, and two shunt operations. Twenty-four of 26 microsurgical operations were transcallosal and two were transcortical. Twenty-four operations (22 transcallosal and two transfrontal approaches) without permanent morbidity were performed by four surgeons. Transient memory deficit from forniceal traction was noted in 26%. The remaining two transcallosal operations, which led to permanent morbidity or mortality, were performed by two different surgeons. Aspiration of cysts performed by four different surgeons carried a 40% risk of transient memory deficit (10% permanent) and an 80% recurrence rate. One patient was found to be cured on radiological studies obtained at the 5-year follow-up review. Seven cysts were followed by means of radiological studies with no treatment for 6 to 37 months. Five of these cysts grew, indicating that younger patients with colloid cysts will probably need surgical treatment. The main causes of unfavorable results were: 1) failure to investigate symptoms that proved fatal; 2) subtotal resection; and 3) surgical complications. Transcallosal microsurgery produced excellent results when performed by experienced surgeons. A colloid cyst of the foramen of Monro is a disease that should be detected before permanent neurological damage has occurred. Permanent morbidity or mortality should not be accepted in modern series of third ventricle colloid cysts.

scholarly journals Excision of Colloid Cyst through Interhemispheric, Transcallosal, Transcavum, Interfornicial Approach

2021 ◽  
Author(s):  
Santosh Kumar ◽  
Nishanth Sadashiva
Keyword(s):  
Third Ventricle ◽  
Colloid Cyst ◽  
Septum Pellucidum ◽  
Cavum Septum Pellucidum ◽  
Transcallosal Approach ◽  
The Third ◽  
Usual Location ◽  
Colloid Cysts

AbstractColloid cysts (CC) occur predominantly in the midline with majority involving roof of the third ventricle. In cases of cavum septum pellucidum (CSP), the surgeon can lose orientation when normal intraventricular structures are not encountered during surgery. We report a patient with CSP, who underwent right frontal parasagittal craniotomy, interhemispheric, transcallosal approach to reach the lesion. Lesion may not be seen in its usual location of foramen of Monroe, and entering the cavum may be confusing because no intraventricular landmarks will be seen. Excision of the cyst through the cavum usually requires interfornicial approach, and this structure must be separated gently to avoid injury.

Complete Microsurgical Resection of Colloid Cysts with a Dual-port Endoscopic Technique

2007 ◽  
Vol 60 (suppl_2) ◽  
pp. ONS-33-ONS-43 ◽  
Author(s):  
Marvin Bergsneider
Keyword(s):  
Third Ventricle ◽  
Colloid Cyst ◽  
Endoscopic Technique ◽  
Attachment Point ◽  
Endoscopic View ◽  
The Third ◽  
High Illumination ◽  
Colloid Cysts ◽  
Dissection Techniques

Abstract Objective: A dual-port endoscopic approach, used for the surgical management of colloid cysts, was developed with the following goals: 1) a direct, unobstructed, high-illumination endoscopic view of the attachment point of the colloid cyst to the tela choroidea, and 2) a gross total resection of the colloid cyst capsule using microsurgical techniques. Methods: Eleven symptomatic, hydrocephalic, colloid cyst patients who underwent operation with a unilateral, precoronal-frontopolar dual-port endoscopic technique were retrospectively assessed. Preoperative magnetic resonance imaging scans were analyzed, comparing the lateral precoronal to the frontopolar approach, to determine the degree of angulation that would be required to directly view the roof of the third ventricle. Clinical outcome and radiographical follow-up were assessed. Results: The frontopolar approach achieved an approach angle to the roof of the third ventricle of only 15 ± 4 degrees compared with 56 ± 6 degrees (P< 0.0001) for the precoronal approach. The view obtained from the frontopolar endoscope allowed excellent visualization of the cyst attachment point. Microsurgical dissection techniques, using many standard microsurgical instruments introduced through the second port, were satisfactorily accomplished. Complete resections were obtained in 10 out of 11 dual-port patients. Worsening of memory deficits occurred in one patient. There was no cyst recurrence with a mean follow-up period of 26 ± 27 months. Conclusion: The dual-port endoscopic technique described is an alternative to classic microsurgical craniotomy approaches. The technique allows excellent visualization of the colloid cyst attachment and permits microdissection techniques.

Radiologic Manifestations of Colloid Cysts: A Pictorial Essay

2013 ◽  
Vol 64 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Oktay Algin ◽  
Evrim Ozmen ◽  
Halil Arslan
Keyword(s):  
Third Ventricle ◽  
Treatment Options ◽  
Cholesterol Content ◽  
Colloid Cyst ◽  
3 Dimensional ◽  
Pictorial Essay ◽  
Colloid Cysts ◽  
Benign Tumours ◽  
Weighted Sequences ◽  
Success Of Treatment

Colloid cysts are among rare benign tumours of the third ventricle. Although the most frequent symptoms are headache and syncope, arrest hydrocephalus or sudden death could appear with colloid cysts. The aim of this pictorial essay was to increase awareness of the clinical presentation, computed tomography (CT) and magnetic resonance (MR) imaging spectrum, and treatment options of the colloid cysts. The data of 11 patients with histopathologically and/or clinically proven colloid cyst were analysed, retrospectively; and the neuroradiologic appearances of the cysts were evaluated. The CT and MR appearance of colloid cysts may change, depending on the viscosity or the cholesterol content of the cysts. However, the cystic content is the most important factor that could affect the success of treatment. Cysts that are especially rich in protein and cholesterol tend to be hyperdense on CT, hypointense on T2-weighted sequences and hyperintense on T1-weighted sequences. These cysts are viscous, and the success of aspiration is significantly low. In the diagnosis and evaluation of small-sized cysts that have an ingredient similar to cerebrospinal fluid, 3-dimensional sequences might be useful. The radiologic appearances of colloid cysts could play an important role in directing these patients to alternative surgical modalities, including resection.

scholarly journals Endoscopic Versus Microsurgical Resection of Third Ventricle Colloid Cysts

2007 ◽  
Vol 34 (2) ◽  
pp. 197-207 ◽  
Author(s):  
Ron T. Grondin ◽  
Walter Hader ◽  
M. Elizabeth MacRae ◽  
Mark G. Hamilton
Keyword(s):  
Endoscopic Resection ◽  
Operative Time ◽  
Third Ventricle ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Stereotactic Aspiration ◽  
Colloid Cysts ◽  
Microsurgical Resection ◽  
Endoscopic Group

Objective:Endoscopic resection of colloid cysts has been performed as an alternative to microsurgical resection and stereotactic aspiration since 1982. To date, there are limited published studies comparing these procedures. In this study, we present the largest series of endoscopic resections published to date and compare outcomes to a cohort of microsurgical resections performed at the same institution.Methods:A retrospective chart review was conducted for all patients in the Calgary Health Region undergoing resection of a colloid cyst between 1991 and 2004. Comparison was made between patients treated with endoscopic resection versus microsurgical resection.Results:Twenty-five endoscopic and nine microsurgical procedures were performed. Complete resection was achieved in 24 of 25 procedures in the Endoscopic group, compared with all 9 procedures in the Microsurgical group. Patients in the Endoscopic group had a reduced operative time (mean 104 minutes versus 217 minutes) and reduced length of stay (3.8 days versus 8.4 days) compared to the Microsurgical group. One patient in the Endoscopic group had a complication (hemiparesis/pulmonary embolus). By contrast, 3 patients in the Microsurgical group had complications (seizure, ventriculitis/bone flap infection, and transient memory deficit). There was one recurrence in each group which both occurred at 5 years follow-up. The mean length of follow-up is 38 months in the Endoscopic group and 33 months in the Microsurgical group.Conclusion:Endoscopic resection of colloid cysts can be performed with significantly lower risk of complication than microsurgical resection and with equivalent surgical success. Operative time and length of hospital stay are both significantly reduced with endoscopic resection.

Surgical resection of third ventricle colloid cysts

1994 ◽  
Vol 81 (2) ◽  
pp. 174-178 ◽  
Author(s):  
Adam I. Lewis ◽  
Kerry R. Crone ◽  
Jamal Taha ◽  
Harry R. van Loveren ◽  
Hwa-Shain Yeh ◽  
...  
Keyword(s):  
Short Term Memory ◽  
Third Ventricle ◽  
Operating Time ◽  
Memory Loss ◽  
Length Of Hospital Stay ◽  
Content Type ◽  
Transcallosal Approach ◽  
Presenting Symptoms ◽  
Colloid Cysts ◽  
Fine Print

✓ It is still not determined which is the best surgical option for third ventricle colloid cysts. Since 1990, the authors have used a steerable fiberscope to remove colloid cysts in seven patients and have performed microsurgery via a transcallosal approach in eight patients. The two techniques were compared for operating time, length of hospital stay, incidence of complications, recurrence, and hydrocephalus, and days spent recuperating before return to work to determine if endoscopic removal of colloid cysts is a safe and effective alternative to microsurgery. Statistical analysis was adjusted for age, sex, and presenting symptoms. Microsurgical cases averaged 206 minutes of operating time whereas endoscopic cases averaged 127 minutes (p = 0.01). For combined days spent in the intensive care unit and on the ward, the patients averaged 9.5 days after microsurgery and 4 days after endoscopy (p = 0.05). Postoperative complications occurred in five of eight patients after microsurgery and in one of seven patients after endoscopy (p = 0.09); complications were transient and primarily related to short-term memory loss. In all patients, preoperative symptoms resolved and the cysts have not recurred. Postoperatively, one patient required a ventriculoperitoneal shunt after microsurgery but all patients were shunt-independent after endoscopy. Patients returned to work an average of 59 days after discharge following microsurgery compared with an average of 26 days after endoscopy (p = 0.05). Compared with transcallosal microsurgery for the removal of colloid cysts, these preliminary results show that a steerable endoscope reduced operating time and that patients spent fewer days in the hospital and returned to work sooner after endoscopy.

COLLOID CYSTS OF THE THIRD VENTRICLE: A REVIEW OF SIXTEEN CASES

2021 ◽  
pp. 62-64
Author(s):  
Y Srinivas Rao ◽  
Hemal Chheda ◽  
Ch Surendra ◽  
M V Vijayasekhar ◽  
K Satya Varaprasad
Keyword(s):  
Benign Lesion ◽  
Third Ventricle ◽  
Clinical Manifestations ◽  
Colloid Cyst ◽  
Surgical Approaches ◽  
Imaging Features ◽  
Complete Excision ◽  
Advantages And Disadvantages ◽  
The Third ◽  
Colloid Cysts

BACKGROUND : Colloid cysts are one of the rare brain tumours and are mostly located in the anterosuperior portion of the third ventricle, between the fornix and surround of Foramen of Monroe. OBJECTIVES: Ÿ 1.To review the demographic information & analyse clinical manifestations of patients presenting with colloid cyst of third ventricle. Ÿ 2.To analyze the advantages and disadvantages of various surgical approaches Ÿ 3.To assess the surgical outcome in colloid cyst patients operated by any method. MATERIALS AND METHODS: A retrospective study was performed on 16 patients who presented with a colloid cyst and underwent surgery at the Department of Neurosurgery, King George Hospital, Andhra Medical College between 2013-2018. They were evaluated based on clinical ndings and imaging features, surgical approaches used for resection and their outcomes. RESULTS: Sixteen cases of colloid cyst of the third ventricle were operated upon between 2013-2018. There were seven male and nine female patients with their ages varying between 9 and 62 years old. Nine patients were operated on by using a transcortical trans-ventricular approach, four using the anterior trans-callosal approach and, three patients by using an endoscopic approach. In all patients, complete excision of the lesions was achieved. CONCLUSION: Colloid cysts, though benign, present surgical challenges because of its deep midline location. Complete excision of the colloid cyst carries an excellent prognosis. Surgery is a safe and effective treatment option for this benign lesion.

scholarly journals COLLOID CYST OF THE THIRD VENTRICLE

2010 ◽  
Vol 17 (01) ◽  
pp. 156-163
Author(s):  
NAVEED ASHRAF ◽  
MUHAMMAD AKMAL AZEEMI ◽  
FAUZIA SAJJAD ◽  
Asma Ghouri
Keyword(s):  
Clinical Success ◽  
Standard Procedure ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Invasive Approach ◽  
Keyhole Surgery ◽  
The Third ◽  
Number Of Patients ◽  
Colloid Cysts ◽  
Microsurgical Resection

Objectives: Cerebrospinal fluid shunting or microsurgical resection of the colloid cysts of the third ventricle have long been a standard treatment. The emergence of neuroendoscopy has lead to its application in various neurosurgical problems. Colloid cyst of the third ventricle is one such pathology where endoscopic treatment has been performed with great clinical success during the past decade. We now Although considered less efficacious than microsurgical excision endoscopic excision is less invasive and much simpler.Objectives: (1) to assess the extent of excision (2) to assess the morbid anatomy of the colloid cyst (3) to assess the risk of complications (4) to assess the functional outcome. Period: Eight years (Jul 2001-June 2009) Materials and Methods: Endoscopic resections of 15 colloid cysts of the third ventricle with obstruction of Foramina of Monroe in all cases. Results: Total removal was achieved in 10 (66.7%) cases. In 5 (33.3%) patients the colloid material was evacuated completely while the remnant of the capsule adherent to its origin was left behind. Two (13.3%) patients developed meningitis one week postoperatively and one diedsubsequently. Nine (60%) patients had excellent recovery as the symptoms were relieved during a period of 3 to 24 months. Five (33.3%) of the total patients required ventriculoperitoneal shunt for obstructivey drocephalus which developed with in 2 weeks after surgery. One out of the total number of patients deteriorated postoperatively on the existing neurological deficit. There has not been any recurrence until now with subtotal excision of the capsule. Conclusions: Keyhole surgery under endoscopic visual control offers an alternative, very effective minimally invasive approach for the excision of colloid cyst of the third ventricle and is likely to replace microsurgical resection as a standard procedure.

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