High recurrence rate following aspiration of colloid cysts in the third ventricle

1993 ◽  
Vol 78 (5) ◽  
pp. 748-752 ◽  
Author(s):  
Tiit Mathiesen ◽  
Per Grane ◽  
Christer Lindquist ◽  
Hans von Holst
Keyword(s):  
Third Ventricle ◽  
High Recurrence Rate ◽  
Term Outcome ◽  
Foramen Of Monro ◽  
Repeat Surgery ◽  
Long Term Outcome ◽  
Content Type ◽  
Stereotactic Aspiration ◽  
The Third ◽  
Colloid Cysts

✓ Sixteen patients treated between 1969 and 1989 for a colloid cyst of the foramen of Monro by stereotactically guided aspiration (not stereotactic extirpation) were evaluated to assess the long-term outcome of the procedure. Thirteen of these patients required reoperation due to an acute comatose state, failure to achieve permanent reduction of the cyst, or symptomatic hydrocephalus. Of these 13, six were treated twice and two were treated three times by stereotactic aspiration. Five patients underwent microsurgical extirpation and three had a shunt placed following a failed aspiration. Failure of the first procedure was detected within the first 2 months after treatment in eight patients and after more than 6 years in seven. Following stereotactic aspiration, three patients experienced a temporary memory deficit and confusion and one patient suffered a central pain syndrome. Eleven of the 26 procedures were followed by a recurrence 6 to 15 years after treatment; seven recurrent cysts were detected after more than 8 years. Of the patients with recurrences, three did not undergo repeat surgery but showed an increase in cyst size at the latest follow-up examination. It is suggested that radical removal by open or stereotactically guided microsurgery is the method of choice since stereotactic aspiration fails to offer a radical or permanent treatment for colloid cysts of the third ventricle.

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.

Colloid cysts of the third ventricle

1974 ◽  
Vol 40 (2) ◽  
pp. 230-235 ◽  
Author(s):  
John R. Little ◽  
Collin S. MacCarty
Keyword(s):  
Third Ventricle ◽  
Normal Pressure ◽  
Colloid Cyst ◽  
Cerebral Vein ◽  
Diagnostic Study ◽  
Progressive Dementia ◽  
Foramen Of Monro ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts

✓ Thirty-eight cases of colloid cyst of the third ventricle are reviewed. Headache was the most frequent complaint but a strong positional relationship, supposedly a pathognomonic feature of this tumor, was seldom seen. A combination of progressive dementia and gait disturbance without evidence of papilledema, resembling the clinical picture in “normal-pressure” hydrocephalus, was present in eight patients. Sudden deterioration and death occurred in four cases; two other deaths were precipitated by lumbar puncture and pneumoencephalography. Ventriculography was the most reliable diagnostic study. Both the demonstration of dilatation of the lateral ventricles and an upward convexity in the initial segment of the internal cerebral vein in five of the 10 angiograms performed were highly suggestive of tumor. Removal of the colloid cyst through a cortical incision in the non-dominant hemisphere was carried out in 21 cases; in six it was necessary to enlarge the foramen of Monro by dividing the ipsilateral anterior column of the fornix. There were three deaths in the early and two in the late postoperative period. The main complication associated with the transventricular approach was the development of seizures.

CT-stereotaxic drainage of colloid cysts in the foramen of Monro and the third ventricle

1987 ◽  
Vol 67 (2) ◽  
pp. 220-223 ◽  
Author(s):  
Mohsen Mohadjer ◽  
Elemer Teshmar ◽  
Fritz Mundinger
Keyword(s):  
Magnetic Resonance Imaging ◽  
Third Ventricle ◽  
Major Advance ◽  
Resonance Imaging ◽  
Foramen Of Monro ◽  
Content Type ◽  
Safe Method ◽  
The Third ◽  
Colloid Cysts ◽  
Fine Print

✓ Colloid cysts in the foramen of Monro and third ventricle account for 0.5% to 1% of all intracranial space-occupying lesions. The introduction of computerized tomography (CT) and magnetic resonance imaging has represented a major advance in the early detection of these cysts. The risks associated with the management of benign space-occupying lesions by open surgical procedures have made it necessary to search for safer techniques. The CT-stereotaxic method provides a simple, precise, and safe method of puncturing deep-seated space-occupying cysts. Between January, 1979, and December, 1984, 12 patients with colloid cysts in the foramen of Monro and third ventricle were operated on by this method. The operations were successful, and there were no intraoperative or postoperative complications. The advantages of the CT-stereotaxic method are discussed and the results are presented.

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.

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.

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.

Combined endoscopic transforaminal-transchoroidal approach for the treatment of third ventricle colloid cysts

2014 ◽  
Vol 120 (6) ◽  
pp. 1471-1476 ◽  
Author(s):  
Maurizio Iacoangeli ◽  
Lucia Giovanna Maria di Somma ◽  
Alessandro Di Rienzo ◽  
Lorenzo Alvaro ◽  
Davide Nasi ◽  
...  
Keyword(s):  
Third Ventricle ◽  
Invasive Procedure ◽  
Colloid Cyst ◽  
Complete Resection ◽  
Safe Alternative ◽  
Foramen Of Monro ◽  
The Third ◽  
Postoperative Mri ◽  
Tela Choroidea ◽  
Colloid Cysts

Colloid cysts are histologically benign lesions whose primary goal of treatment should be complete resection to avoid recurrence and sudden death. Open surgery is traditionally considered the standard approach, but, recently, the endoscopic technique has been recognized as a viable and safe alternative to microsurgery. The endoscopic approach to colloid cysts of the third ventricle is usually performed through the foramen of Monro. However, this route does not provide adequate visualization of the cyst attachment on the tela choroidea. The combined endoscopic transforaminal-transchoroidal approach (ETTA), providing exposure of the entire cyst and a better visualization of the tela choroidea, could increase the chances of achieving a complete cyst resection. Between April 2005 and February 2011, 19 patients with symptomatic colloid cyst of the third ventricle underwent an endoscopic transfrontal-transforaminal approach. Five of these patients, harboring a cyst firmly adherent to the tela choroidea or attached to the middle/posterior roof of the third ventricle, required a combined ETTA. Postoperative MRI documented a gross-total resection in all 5 cases. There were no major complications and only 1 patient experienced a transient worsening of the memory deficit. To date, no cyst recurrence has been observed. An ETTA is a minimally invasive procedure that can allow for a safe and complete resection of third ventricle colloid cysts, even in cases in which the lesions are firmly attached to the tela choroidea or located in the middle/posterior roof of the third ventricle.

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 Death of a 22-Year-Old Female Attributed to Complications of a Colloid Cyst in the Third Ventricle

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S76-S76
Author(s):  
Gary Wu ◽  
Jennifer Hammers
Keyword(s):  
Sudden Death ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Memory Loss ◽  
Colloid Cyst ◽  
Intracranial Tumors ◽  
Foramen Of Monro ◽  
Acute Hydrocephalus ◽  
The Third ◽  
Colloid Cysts

Abstract Colloid cysts are rare lesions that account for up to 2% of all intracranial tumors. They are commonly found posterior to the foramen of Monro in the third ventricle and classified as benign lesions due to their slow-growing nature. Diagnosis of colloid cysts are often incidental finds on diagnostic imaging or at autopsy. The strategic location of these cysts primary causes gradual or acute hydrocephalus, as evidenced by flattened gyri and deepened sulci on MRI, nausea, vomiting, and papilledema. Enlargement of the cyst itself can cause a mass effect, which commonly presents with symptoms of ataxia, memory loss, and rapid neurologic deterioration. Microsurgery, endoscopic removal, and stereotactic aspiration are cited to be the most commonly employed treatments in the management of colloid cysts. However, there is no one procedure better than another; the benefits and limitations of several procedures are discussed. Treatment of choice is weighed by clinical judgment and surgical experience that vary between neurosurgeons. Although benign, colloid cysts rarely but can lead to sudden death. Therefore, it is important to consider colloid cysts and other intracranial tumors on the differential diagnosis when presented with acute hydrocephalus and papilledema. We report a case of sudden death in a 22-year-old black female due to obstructive hydrocephalus by a colloid cyst in the third ventricle.

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