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.

A comparative study on ventriculographic and computerized tomography-guided determinations of brain targets in functional stereotaxis

1990 ◽  
Vol 73 (4) ◽  
pp. 565-571 ◽  
Author(s):  
Marwan I. Hariz ◽  
A. Tommy Bergenheim
Keyword(s):  
Comparative Study ◽  
Computerized Tomography ◽  
Third Ventricle ◽  
Ct Scans ◽  
Noninvasive Technique ◽  
Content Type ◽  
Anterior Displacement ◽  
The Third ◽  
Ct Measurements ◽  
Fine Print

✓ Thalamic, pallidal, and hypothalamic targets were determined in 16 patients by a stereotactic computerized tomography (CT) study using a noninvasive technique with Laitinen's Stereoadapter. At surgery, the Stereoadapter was remounted to the head and the stereotactic CT coordinates were transferred to the Stereoguide without radiography. Air ventriculography was then carried out. The positions of the anterior and posterior commissures (AC and PC), the length of the intercommissural (IC) line, the width of the third ventricle, and the stereotactic coordinates of the target were measured on the ventriculograms and compared to the stereotactic CT measurements. The study showed that the width of the third ventricle was significantly larger on the ventriculograms than on the stereotactic CT scans, whereas the length of the IC line was not significantly different. The differences in the coordinates of the target and of the AC and PC were statistically significant only for the anteroposterior (y) coordinate. Both commissures as well as the surgical target lay, on average, 1.0 mm more anteriorly on the ventriculograms than on the stereotactic CT study. It is concluded that air ventriculography may cause slight anterior displacement of the midbrain structures. The surgical coordinates of the targets based on the stereotactic CT study with the Stereoadapter were on average as accurate as those obtained with ventriculography; therefore, ventriculography may become superfluous in functional stereotaxis.

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.

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.

Documentation of fourth ventricle entrapment by metrizamide ventriculography with CT scanning

1981 ◽  
Vol 55 (5) ◽  
pp. 838-840 ◽  
Author(s):  
Mauricio Collada ◽  
Joseph Kott ◽  
David G. Kline
Keyword(s):  
Cerebrospinal Fluid ◽  
Computerized Tomography ◽  
Fourth Ventricle ◽  
Ct Scanning ◽  
Ct Scans ◽  
Communicating Hydrocephalus ◽  
Content Type ◽  
Ventriculoperitoneal Shunts ◽  
Fine Print

✓ Documentation by metrizamide ventriculography with computerized tomography (CT) of fourth ventricle entrapment is presented. Reevaluation of the cerebrospinal fluid pathways is suggested whenever fourth ventricle enlargment is seen on CT scans of patients with ventriculoperitoneal shunts for communicating hydrocephalus.

Enterogenous cyst of the fourth ventricle

1981 ◽  
Vol 54 (6) ◽  
pp. 836-838 ◽  
Author(s):  
Farhad Afshar ◽  
Carl L. Scholtz
Keyword(s):  
Spinal Cord ◽  
Cyst Wall ◽  
Fourth Ventricle ◽  
Third Ventricle ◽  
Enterogenous Cyst ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
The Relationship ◽  
Fine Print

✓ A case of a benign cyst within the fourth ventricle is described. The histology of the cyst wall lining resembled that of an enterogenous cyst of the spinal cord. The relationship between this cyst, colloid cysts of the third ventricle, and enterogenous cysts of the spinal cord is discussed.

Natural history of asymptomatic colloid cysts of the third ventricle

1999 ◽  
Vol 91 (3) ◽  
pp. 364-369 ◽  
Author(s):  
Bruce E. Pollock ◽  
John Huston
Keyword(s):  
Natural History ◽  
Third Ventricle ◽  
Benign Tumors ◽  
Content Type ◽  
The Third ◽  
History Of ◽  
Colloid Cysts ◽  
The Mean ◽  
Fine Print

Object. To determine the natural history of colloid cysts of the third ventricle in patients in whom the cysts were incidentally discovered, the authors retrospectively reviewed cases observed during the modern neuroimaging era (1974–1998).Methods. During this 25-year interval, 162 patients with colloid cysts were examined and cared for at our center. Sixty-eight patients (42%) were thought to be asymptomatic with regard to their colloid cyst and observation with serial neuroimaging was recommended. The mean patient age was 57 years at the time of diagnosis (range 7–88 years) and the mean cyst size was 8 mm (range 4–18 mm). Computerized tomography scanning revealed a hyperdense cyst in 49 (84%) of 58 patients. Three patients were excluded from the study because they died of unrelated causes within 6 months of scanning and seven patients were lost to follow-up review. Clinical follow-up evaluation was available at a mean of 79 months (range 7–268 months) in the remaining 58 patients. The numbers of patients who participated in follow-up review at 2, 5, and 10 years after diagnosis were 40, 28, and 14, respectively. The incidences of symptomatic progression related to the cyst were 0%, 0%, and 8% at 2, 5, and 10 years, respectively. No patient died suddenly during the follow-up interval. Two (6%) of 34 patients in whom follow-up imaging was performed either exhibited cyst growth (one patient) or experienced hydrocephalus (one patient) at a mean of 41 months after diagnosis (range 4–160 months).Conclusions. Patients in whom asymptomatic colloid cysts are diagnosed can be cared for safely with observation and serial neuroimaging. If a patient becomes symptomatic, the cyst enlarges, or hydrocephalus develops, prompt neurosurgical intervention is necessary to prevent the occurrence of neurological decline from these benign tumors.

High risk of acute deterioration in patients harboring symptomatic colloid cysts of the third ventricle

2002 ◽  
Vol 96 (6) ◽  
pp. 1041-1045 ◽  
Author(s):  
Philip C. de Witt Hamer ◽  
Marco J. T. Verstegen ◽  
Rob J. De Haan ◽  
W. Peter Vandertop ◽  
Ralph T. W. M. Thomeer ◽  
...  
Keyword(s):  
The Netherlands ◽  
Third Ventricle ◽  
Multivariate Logistic Regression Analysis ◽  
Symptomatic Patient ◽  
Colloid Cyst ◽  
Duration Of Symptoms ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
Fine Print

Object. Patients harboring colloid cysts of the third ventricle can present with acute neurological deterioration, or the first indication of the lesion may appear when the patient suddenly dies. The risk of such an occurrence in a patient already identified as harboring a colloid cyst is unknown. The goal of this study was to estimate the risk of acute deterioration in patients with colloid cysts. Methods. A retrospective study was made of a cohort of patients with newly diagnosed colloid cysts who were recruited in The Netherlands between January 1, 1993, and December 31, 1997. Seventy-eight patients were identified, all of whom displayed symptoms. Twenty-five patients (32%) presented with symptoms of acute deterioration; four patients died suddenly and the cysts were discovered at autopsy. The overall mortality rate was 12%. Results of a multivariate logistic regression analysis demonstrated that no subgroup of patients presenting without acute deterioration could be identified on the basis of patient age, duration of symptoms, cyst size, or the presence of hydrocephalus. The national incidence of colloid cysts in The Netherlands is 1/106 person-years; the prevalence was estimated to be 1800 asymptomatic colloid cysts. Conclusions. Acute deterioration was a frequent presentation among a national cohort of Dutch patients harboring symptomatic colloid cysts. The risk of acute deterioration in a symptomatic patient with a colloid cyst in The Netherlands is estimated to be 34%. The estimated risk for an asymptomatic patient with an incidental colloid cyst is significantly lower. These results strongly advocate the selection of surgical treatment for patients with symptomatic colloid cysts.

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