Neuroepithelial (colloid) cysts of the septum pellucidum

1975 ◽  
Vol 43 (1) ◽  
pp. 69-73 ◽  
Author(s):  
Ivan Ciric ◽  
Israel Zivin
Keyword(s):  
Third Ventricle ◽  
Clinical History ◽  
Septum Pellucidum ◽  
Review Of Literature ◽  
Developmental Anatomy ◽  
Content Type ◽  
Transseptal Approach ◽  
Colloid Cysts ◽  
Velum Interpositum ◽  
Neuroepithelial Cysts

✓ The authors present two cases of neuroepithelial (colloid) cysts found above the diencephalic roof, occupying the space between the two fornices and the two leaves of the septum pellucidum, and describe the clinical history, neurological, and neuroradiological findings. Both lesions were removed through a right transventricular-transseptal approach. No other report of such a lesion in this location could be found in the review of literature. The pathogenesis of these cysts, both above and below the diencephalic roof, is discussed in light of the developmental anatomy of the area under consideration. In view of their origin from the neuroepithelium in the diencephalic roof, whether by a process of invagination into the third ventricle or by evagination into the velum interpositum, the so-called colloid cysts are more appropriately termed neuroepithelial cysts.

Changing concepts in the treatment of colloid cysts

1987 ◽  
Vol 66 (2) ◽  
pp. 186-191 ◽  
Author(s):  
Walter A. Hall ◽  
L. Dade Lunsford
Keyword(s):  
Third Ventricle ◽  
Ct Scanning ◽  
Morbidity Rate ◽  
Ct Guided ◽  
Content Type ◽  
Persistent Symptoms ◽  
The Third ◽  
Stereotaxic Surgery ◽  
Colloid Cysts ◽  
The University

✓ Since computerized tomography (CT) scanning became available at the University Health Center of Pittsburgh in July, 1975, 17 patients have undergone removal of colloid cysts of the third ventricle by transfrontal, transcallosal, or stereotaxic surgery. All patients presented with symptoms and signs of increased intracranial pressure; CT scanning proved to be the best neurodiagnostic test to define the colloid cysts. Since the development of CT-guided stereotaxic surgery, the authors have preferentially performed stereotaxic aspiration in seven patients; three of these subsequently required craniotomies to remove residual cysts producing persistent symptoms. The viscosity of the intracystic colloid material and/or displacement of the cyst away from the aspiration needle were reasons for unsuccessful aspiration; the CT appearance did not correlate with the ability to aspirate the lesion by the stereotaxic technique. Postoperative patency of the ventricular system was documented by intraoperative CT ventriculography performed during stereotaxic surgery. Removal of the cyst wall was not necessary. Because of the low associated morbidity rate, percutaneous stereotaxic aspiration is recommended as the initial treatment of choice for colloid cysts of the third ventricle. If stereotaxic aspiration fails and symptoms persist, craniotomy should be performed.

Endoscopic treatment of colloid cysts of the third ventricle

1998 ◽  
Vol 89 (6) ◽  
pp. 1062-1068 ◽  
Author(s):  
M. Samy Abdou ◽  
Alan R. Cohen
Keyword(s):  
Surgical Technique ◽  
Endoscopic Resection ◽  
Endoscopic Treatment ◽  
Third Ventricle ◽  
Content Type ◽  
Stereotactic Aspiration ◽  
The Third ◽  
Endoscopic Evacuation ◽  
Colloid Cysts ◽  
Fine Print

✓ The surgical technique for the endoscopic evacuation of colloid cysts of the third ventricle in 13 patients is described. The authors conclude that endoscopic resection of these lesions is a useful addition to the current surgical repertoire and a viable alternative to stereotactic aspiration or open craniotomy.

Neuroepithelial (colloid) cyst of the third ventricle in identical twins

1986 ◽  
Vol 65 (3) ◽  
pp. 401-403 ◽  
Author(s):  
Abdel Wahab M. Ibrahim ◽  
Hisham Farag ◽  
Mohammed Naguib ◽  
Ezzeldin Ibrahim
Keyword(s):  
Cerebrospinal Fluid ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
Fluid Pathway ◽  
Ocular Signs ◽  
Fine Print

✓ Colloid cysts of the third ventricle are described in middle-aged twin brothers. One of them presented with recurrent attacks of headache. In this patient the cyst had reached a size large enough to obstruct the cerebrospinal fluid pathway, resulting in hydrocephalus. The twin brother, although asymptomatic, was suspected of the anomaly and investigated because of the similarity of his ocular signs. The diagnosis was confirmed by computerized tomography in both the patient and his brother. The latter proved to have a smaller colloid cyst situated anteriorly in the third ventricle with no obstructive hydrocephalus. The patient was successfully operated on, while the brother is still under observation. Both brothers have had bilateral cataracts, retinal detachments, and left lateral rectus palsies. The familial occurrence of colloid cysts and their association with these ocular findings have apparently not been described before.

Treatment of colloid cysts of the third ventricle by stereotaxic microsurgical laser craniotomy

1989 ◽  
Vol 70 (4) ◽  
pp. 525-529 ◽  
Author(s):  
Chad D. Abernathey ◽  
Dudley H. Davis ◽  
Patrick J. Kelly
Keyword(s):  
Third Ventricle ◽  
Total Removal ◽  
Total Resection ◽  
Content Type ◽  
The Third ◽  
Cyst Aspiration ◽  
Colloid Cysts ◽  
Mass Lesions ◽  
Fine Print

✓ The therapeutic strategies employed in the management of anterior third-ventricular mass lesions remain controversial. Resection by conventional craniotomy, whether via a transcallosal or transcortical approach, carries well-known risks and limitations. Alternatively, in this region traditional stereotaxy has been relegated to use with biopsy only or cyst aspiration procedures. Combining aspects of both conventional and stereotaxic techniques has allowed total removal of 12 colloid cysts in six women and six men ranging in age from 25 to 71 years. No mortality and minimal morbidity have been associated with the procedures. There has been no evidence of recurrence in an average follow-up period of 19 months. By coupling the benefits of stereotaxic precision and localization to the microsurgical management of colloid cysts, several rewards have been realized: 1) only a limited cortical dissection is needed; 2) the hazards of callosal or forniceal injury can be avoided; 3) the lesion is easily localized regardless of ventricular size; 4) hemostasis can be readily achieved with bipolar cautery or defocused laser power; and 5) most importantly, a total resection is possible with little risk to the patient. Stereotaxic microsurgical laser craniotomy provides a new option for the management of colloid cysts and other anterior third-ventricular lesions.

Sudden deterioration and death in patients with benign tumors of the third ventricle area

1986 ◽  
Vol 64 (2) ◽  
pp. 216-223 ◽  
Author(s):  
John W. Ryder ◽  
B. K. Kleinschmidt-DeMasters ◽  
Ted S. Keller
Keyword(s):  
Risk Factors ◽  
Sudden Death ◽  
Third Ventricle ◽  
Benign Tumors ◽  
Close Monitoring ◽  
Review Of The Literature ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
The Subject

✓ Although sudden deterioration and death is a widely recognized complication in patients with benign tumors of the third ventricle area, the exact incidence of this dreaded occurrence is unknown and the reports in the literature on the subject are largely anecdotal. Neither risk factors nor the etiology of the sudden death have been analyzed. The vast majority of these benign tumors are colloid cysts, and the presence and degree of ventricular dilatation and herniation associated with these tumors as cited in the reports are quite variable. The authors report a case of sudden death in a 27-year-old woman with a subependymoma of the left lateral and third ventricles. A review of the literature is included in an attempt to discern identifiable risk factors for sudden death in patients with tumors of the third ventricle area. Since this potential complication is known to exist in patients with otherwise benign tumors amenable to surgical resection, the authors recommend either prompt removal of the tumor on discovery or close monitoring of the patient if surgery is to be delayed.

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.

Third ventricular xanthogranulomas clinically and radiologically mimicking colloid cysts

1994 ◽  
Vol 81 (4) ◽  
pp. 605-609 ◽  
Author(s):  
Stephen B. Tatter ◽  
Christopher S. Ogilvy ◽  
Jeffrey A. Golden ◽  
Robert G. Ojemann ◽  
David N. Louis
Keyword(s):  
Mr Imaging ◽  
Histopathological Examination ◽  
Third Ventricle ◽  
Contrast Material ◽  
Colloid Cyst ◽  
Mr Images ◽  
Intravenous Contrast ◽  
Content Type ◽  
Stereotactic Aspiration ◽  
Colloid Cysts

✓ Two cases are reported of third ventricle masses that were clinically and radiographically indistinguishable from pure colloid cysts. A 21- and a 36-year-old man presented with 5-year and 10-day histories of headache, respectively. Magnetic resonance (MR) imaging revealed smooth, homogeneous masses in the anterior third ventricle that were iso- to hyperintense on T1-weighted MR images and hyperintense on T2-weighted images. There was little enhancement with intravenous contrast material. In both patients, craniotomies were performed and histopathological examination revealed xanthogranulomas of the choroid plexus with only microscopic foci of colloid cyst-like structures. These cases illustrate that xanthogranulomas of the third ventricle may clinically and radiologically mimic pure colloid cysts, that a range of MR imaging signals can be seen, and that craniotomy rather than stereotactic aspiration is the indicated treatment.

CT-assisted stereotaxic aspiration of colloid cysts of the third ventricle

1985 ◽  
Vol 62 (2) ◽  
pp. 238-242 ◽  
Author(s):  
Juan J. Rivas ◽  
Ramiro D. Lobato
Keyword(s):  
Computerized Tomography ◽  
Third Ventricle ◽  
Ct Scanning ◽  
Ct Scans ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
Reproducible Method ◽  
Inner Diameter ◽  
Fine Print

✓ A technique is reported for the stereotaxic evacuation of colloid cysts of the third ventricle using a stereotaxic system adapted for computerized tomography (CT) scanning. This is an accurate, simple, and reproducible method that avoids the risks of direct approaches. Successful intracystic aspiration resulting in the cure of the patient may be difficult when the viscosity of the cyst contents is high. Thus, the authors use a large cannula (1.8 mm in inner diameter) to evacuate cysts that appear hyperdense on CT scans; these seem to contain a thicker colloid material than hypodense or isodense cysts.

The transcallosal—transforaminal approach to the third ventricle with regard to the venous variations in this region

1997 ◽  
Vol 87 (5) ◽  
pp. 706-715 ◽  
Author(s):  
Uğur Türe ◽  
M. Gazi Yaşargil ◽  
Ossama Al-Mefty
Keyword(s):  
Third Ventricle ◽  
Anatomical Study ◽  
Surgical Approaches ◽  
Cerebral Vein ◽  
Foramen Of Monro ◽  
Content Type ◽  
The Third ◽  
Transforaminal Approach ◽  
Velum Interpositum ◽  
Fine Print

✓ Surgical approaches to lesions located in the anterior and middle portions of the third ventricle are challenging, even for experienced neurosurgeons. Various exposures involving the foramen of Monro, the choroidal fissure, the fornices, and the lamina terminalis have been advocated in numerous publications. The authors conducted a microsurgical anatomical study in 20 cadaveric brain specimens (40 hemispheres) to identify an exposure of the third ventricle that would avoid compromising vital structures. An investigation of the variations in the subependymal veins of the lateral ventricle in the region of the foramen of Monro was performed, as these structures are intimately associated with the surgical exposure of the third ventricle. In 16 (80%) of the brain specimens studied, 19 (47.5%) of the hemispheres displayed a posterior location of the anterior septal vein—internal cerebral vein (ASV—ICV) junction, 3 to 13 mm (average 6 mm) beyond the foramen of Monro within the velum interpositum, not adjacent to the posterior margin of the foramen of Monro (the classic description). Based on this finding, the authors advocate opening the choroidal fissure as far as the ASV—ICV junction to enlarge the foramen of Monro posteriorly. This technique achieves adequate access to the anterior and middle portions of the third ventricle without causing injury to vital neural or vascular structures. The high incidence of posteriorly located ASV—ICV junctions is a significant factor influencing the successful course of surgery. Precise planning of the surgical approach is possible, because the location of the junction is revealed on preoperative neuroradiological studies, in particular on magnetic resonance venography. It can therefore be determined in advance which foramen of Monro qualifies for posterior enlargement to gain the widest possible access to the third ventricle. This technique was applied in three patients with a third ventricular tumor, and knowledge of the venous variations in this region was an important resource in guiding the operative exposure.

Empty sella secondary to suprasellar colloid cyst of foregut (respiratory) origin

1979 ◽  
Vol 51 (1) ◽  
pp. 114-117 ◽  
Author(s):  
Dwight C. Evans ◽  
Martin G. Netsky ◽  
Verne E. Allen ◽  
Vira Kasantikul
Keyword(s):  
Cerebrospinal Fluid ◽  
Third Ventricle ◽  
Sella Turcica ◽  
Colloid Cyst ◽  
Empty Sella ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
Third Ventricular Cyst ◽  
Fine Print

✓ An enlarged sella turcica was discovered in a 40-year-old man who had bitemporal headaches. A pneumoencephalograph revealed a third ventricular cyst, dilated lateral ventricles, and an empty sella. The colloid cyst was lined by foregut epithelium, probably originating in the respiratory tract, and dense connective tissue. This case is the first instance of an empty sella associated with a colloid cyst of the third ventricle. It is proposed that enlargement of the mass in the third ventricle caused increased pulsation pressure of the cerebrospinal fluid, and that in the presence of an incompetent diaphragma sellae the subarachnoid space expanded into the sella. The origin of third ventricle cysts is reconsidered. It is concluded that suprasellar colloid cysts may arise from endoderm, ectoderm, neuroepithelium, or a combination of these epithelia.

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