Colloid Cyst Of Third Ventricle Research Articles

502 Endoscopic Versus Microsurgery Resection of Third Ventricle Colloid Cysts: A Single-center Case-series of 140 Consecutive Patients

INTRODUCTION: The resection of colloid cysts of third ventricle can be done with either open microsurgery or endoscopy with each having different cons and pros. METHODS: Data of patients who underwent surgical resection of third ventricle colloid cyst via either endoscopic or microsurgery approach by a single surgeon between 2005-2020 were retrospectively collected. After administration of criteria, 140 records were retrieved (60 through endoscopic and 80 by trans-cranial microsurgery). Clinical and surgical measures were compared between approaches after adjustment for confounders with generalized linear multivariate regression. RESULTS: Length of hospital stay, postoperative meningitis, and operation time, cyst size, and baseline comorbidities did not differ between groups. Gross total resection (GTR) was achieved for all cases in microsurgery group while in endoscopic group it was lower (90% vs 100%; p = 0.005). Intraoperative hemorrhage occurred in 14 (23.3%) of endoscopic patients while for microscopic group it was zero (p < 0.001). Post-operative shunt was required for two patients (one in endoscopic group and the other in microscopic group). Two patients had tumor recurrence, both being in endoscopic group. No mortality was detected in either group. Multivariate analyses were insignificant for the effects of clinical and demographic factors in occurrence of worse surgical outcomes (non-GTR and hemorrhage). CONCLUSIONS: Rate of intra-operative hemorrhage was higher in endoscopic method and GTR was lower, even after adjustment for other factors. This could be due to technologic shortcomings and limited space for resection maneuvers and complication management.

Colloid Cyst: Revision of Third Ventricular Zones for Risk Stratification of Hydrocephalus

We sought to reclassify the "anatomic risk zones of colloid cysts" as proposed by Beaumont etal, by proposing newer landmarks, and to assess predictive value for the risk of occurrence of hydrocephalus with the new classification compared with the old. A retrospective cohort of 122 cases of colloid cyst of third ventricle were categorized into zones 1, 2, or 3 based on Beaumont's classification (old zone) and our classification (new zone) based on radiologic images. We attempted to recategorize these zones by assigning new anatomic landmarks. The difference in zonal distribution of colloid cyst and association with hydrocephalus was studied using the 2 methods of zonal classification. Per the old zone classification, 3/122 patients were in zone 2, whereas 21/122 were in zone 2 per the new zone classification. The new zone method had a higher specificity (36.21% vs. 5.263 %) and positive predictive value (63.37% vs. 54.23%) for occurrence of hydrocephalus in patients with colloid cyst. The Spearman correlation showed better correlation with the new method for occurrence of hydrocephalus (rho= 0.4 [P < 0.00000] vs. 0.2 [P= 0.011]). Symptomatic colloid cysts are more likely to develop hydrocephalus and sudden acute deterioration. The colloid cyst risk score is a step towards objective decision making, with scope for modification such as the one that we have attempted with new zone classification to achieve superior prognostic ability.

Endoscopic versus Microsurgical Resection of Third Ventricle Colloid Cysts: A Single-Center Case Series of 140 Consecutive Patients

Both endoscopic and microsurgery trans-cortical resection methods are used for colloid cysts of third ventricle but they are not compared to each other in regard to benefits and pitfalls. Data of patients who underwent surgical resection of third ventricle colloid cyst via either endoscopic or microsurgery approach by a single surgeon from 2005 to 2020 were retrospectively collected. After administration of criteria, 140 records were retrieved (60 patients through endoscopic resection and 80 patients by trans-cranial microsurgery approach). Clinical and surgical measures were compared between the two types of surgery after adjustment for confounders. Length of hospital stay, postoperative meningitis, and operation time, cyst size, and baseline comorbidities was similar between groups. Gross total resection (GTR) was achieved for all cases in microsurgery group while in endoscopic group it was lower (90% vs 100%; p=0.005). Intraoperative hemorrhage occurred in 14 (23.3%) of endoscopic patients while for microscopic group it was zero (p<0.001). Post-operative shunt was required for two patients (one in endoscopic group and the other in microscopic group). Two patients had tumor recurrence, both being in endoscopic group. No mortality was detected in either group. Multivariate analyses were insignificant for confounding effects of clinical and demographic factors in occurrence of worse surgical outcomes (non-GTR and hemorrhage). In our series the rate of intra-operative hemorrhage was higher in endoscopic method and GTR was lower, even after adjustment for other factors. This could be due to technologic shortcomings and limited space for resection maneuvers and complication management.

In Reply to the Reply to the Letter to the Editor Regarding “Postexercise Death Due to Hemorrhagic Colloid Cyst of Third Ventricle: Case Report and Literature Review”

In Reply to the Reply to the Letter to the Editor Regarding “Postexercise Death Due to Hemorrhagic Colloid Cyst of Third Ventricle: Case Report and Literature Review”

In Reply to the Letter to the Editor Regarding “Postexercise Death Due to Hemorrhagic Colloid Cyst of Third Ventricle: Case Report and Literature Review”

In Reply to the Letter to the Editor Regarding “Postexercise Death Due to Hemorrhagic Colloid Cyst of Third Ventricle: Case Report and Literature Review”

Letter to the Editor Regarding “Postexercise Death Due to Hemorrhagic Colloid Cyst of Third Ventricle: Case Report and Literature Review”

Letter to the Editor Regarding “Postexercise Death Due to Hemorrhagic Colloid Cyst of Third Ventricle: Case Report and Literature Review”

Surgical approaches for resection of third ventricle colloid cysts: meta-analysis

Although outcome studies and systematic reviews have been published on the surgical treatment of third ventricle colloid cysts (TVCC), there are no meta-analyses that compare the outcomes for various surgical approaches. This meta-analysis assesses the outcomes and complications for transcortical, transcallosal, and endoscopic surgical approaches used to excise TVCCs. A meta-analysis of surgically excised TVCCs was performed with an assessment of outcome for transcortical, transcallosal, and endoscopic approaches. A random-effects model analyzed the extent of surgical excision. The analysis included reports that compared at least two of these surgical approaches, for a total of 11 studies comprising a population of 301 patients. The transcortical approach was associated with a higher incidence of complete excision compared to the endoscopic approach (OR = 0.137, p = 0.041), with no significant differences observed between transcortical and transcallosal approaches, and between transcallosal and endoscopic approaches. Comparison between endoscopic and pooled microsurgical approaches was also insignificant (OR = 0.22, p = 1). The risk of motor weakness was increased with the transcortical approach compared to the endoscopic approach (OR = 6.10, p = 0.018). There were no significant differences between transcortical and transcallosal approaches regarding newly onset seizures, and no significant mortality differences between all three approaches. This study demonstrates that microsurgical approaches are associated with a greater extent of resection compared to endoscopic approaches; however, best results are likely achieved based on the surgeon's expertise, flexibility, and case review.

Retrospective evaluation of endoscopic treatment in colloid cyst of the third ventricle.

IntroductionEndoscopic methods have gained a well-established position in surgical treatment of colloid cysts of third ventricle. However, the possibility of total tumor removal with this method and the long-term effectiveness of treatment are being questioned.AimPersonal twenty years’ experience in treatment of third ventricle colloid cysts is presented on the basis of retrospective analysis.Material and methodsThe study group included 58 patients diagnosed by neuroimaging (head CT/MRI) with third ventricle colloid cyst. Post-hospital follow-up ranged from 18 to 42 months. Long-term follow-up head CT/MRI was performed in 39 patients.ResultsThe colloid cyst was removed totally in 47 (81%) patients. In 11 cases, the colloid cyst’s wall was tightly adherent to the roof of the third ventricle, which limited the radicality of the procedure. Sixteen patients demonstrated memory impairments, 4 patients epilepsy and another 2 akinetic mutism in the direct postoperative course. One patient died as a result of complications unrelated to the procedure. The average hospitalization was 5 days. In the late period after surgery, remission of the most, previously, reported ailments and symptoms has been reported. Surgical treatment for hydrocephalus was needed in 7 patients. In 3 cases cyst recurrence was diagnosed which required reoperation.ConclusionsThe endoscopic methods allow the total removal of a third ventricle colloid cyst in most patients. Leaving a small coagulated fragment of the cyst rarely results in its recurrence. This method results in effective treatment with a low complications rate, shortens hospitalization time and brings the patient a high level of satisfaction with a quick recovery.

Colloid cyst of third ventricle: Histopathological and ultrastructural study

Cysts occupying the third ventricle are rare lesions and may appear as an unusual cause of hydrocephalic crisis. A 40-year old woman with headache and one episode of fainting attack was diagnosed with a cystic lesion in the third ventricle after brain MRI study. She was operated with the pre-operative diagnosis of a colloid cyst. A yellowish, thick and mucoid cyst was observed intra-operatively. The total removal of the cyst was done along with the cyst wall. On histopathological evaluation, the cyst wall was lined by ciliated cuboidal to pseudostratified columnar epithelium resting on an eosinophilic basement membrane. The ultrastructural study showed the characteristic 9+2 pattern of cilia. Immunohistochemistry showed positive staining for epithelial membrane antigen (EMA), cytokeratin (CK), and negative staining for Glial fibrillary acidic protein (GFAP). Histopathological and ultrastructural findings confirm the diagnosis of a colloid cyst of third ventricles favoring the endodermal origin of the cyst.

Development and evaluation of a patient-specific surgical simulator for endoscopic colloid cyst resection.

Endoscopic resection of third-ventricle colloid cysts is technically challenging due to the limited dexterity and visualization provided by neuroendoscopic instruments. Extensive training and experience are required to master the learning curve. To improve the education of neurosurgical trainees in this procedure, a synthetic surgical simulator was developed and its realism, procedural content, and utility as a training instrument were evaluated. The simulator was developed based on the neuroimaging (axial noncontrast CT and T1-weighted gadolinium-enhanced MRI) of an 8-year-old patient with a colloid cyst and hydrocephalus. Image segmentation, computer-aided design, rapid prototyping (3D printing), and silicone molding techniques were used to produce models of the skull, brain, ventricles, and colloid cyst. The cyst was filled with a viscous fluid and secured to the roof of the third ventricle. The choroid plexus and intraventricular veins were also included. Twenty-four neurosurgical trainees performed a simulated colloid cyst resection using a 30° angled endoscope, neuroendoscopic instruments, and image guidance. Using a 19-item feedback survey (5-point Likert scales), participants evaluated the simulator across 5 domains: anatomy, instrument handling, procedural content, perceived realism, and confidence and comfort level. Participants found the simulator's anatomy to be highly realistic (mean 4.34 ± 0.63 [SD]) and appreciated the use of actual instruments (mean 4.38 ± 0.58). The procedural content was also rated highly (mean 4.28 ± 0.77); however, the perceived realism was rated slightly lower (mean 4.08 ± 0.63). Participants reported greater confidence in their ability to perform an endoscopic colloid cyst resection after using the simulator (mean 4.45 ± 0.68). Twenty-three participants (95.8%) indicated that they would use the simulator for additional training. Recommendations were made to develop complex case scenarios for experienced trainees (normal-sized ventricles, choroid plexus adherent to cyst wall, bleeding scenarios) and incorporate advanced instrumentation such as side-cutting aspiration devices. A patient-specific synthetic surgical simulator for training residents and fellows in endoscopic colloid cyst resection was successfully developed. The simulator's anatomy, instrument handling, and procedural content were found to be realistic. The simulator may serve as a valuable educational tool to learn the critical steps of endoscopic colloid cyst resection, develop a detailed understanding of intraventricular anatomy, and gain proficiency with bimanual neuroendoscopic techniques.

Anterior trans-frontal endoscopic resection of third-ventricle colloid cyst: how I do it

The endoscopic technique has been recognised as a viable and safe alternative to microsurgery for the treatment of third-ventricle colloid cyst. However, the standard precoronal endoscopic approach does not always provide an adequate visualisation of the attachment of the cyst to the velum interpositum. Using a more anterior approach, it is easier to reach the roof of the cyst and its possible adherences with the tela choroidea. The authors describe step by step the anterior trans-frontal endoscopic approach for management of third ventricle colloid cyst. The described approach has shown to be safe, quick and effective for the treatment of third-ventricle colloid cyst.

Endoscopic Treatment of Colloid Cysts of Third Ventricle: Study of Three Cases

Introduction: Colloid cyst of the third ventricle is a rare intracranial benign tumor. Traditionally, treatment is carried out by transcallosal or transcortical transventricular approach. Currently, the endoscopic treatment of these lesions is increasingly used. We reported our preliminary experience about three cases of colloid cysts treated by neuroendoscopy. Methods and Patients: We conducted a retrospective study on the analysis of medical records of three patients with colloid cyst who had been operated endoscopically in our department. We used a rigid neuroendoscope of 2.7 mm in diameter, with an optical 30°. Coagulation of the wall, followed by a puncture aspiration of cystic contents and partial resection of its wall were performed during the surgery. The mean follow-up time was two years. Results: Patients were 35, 47, and 53 years old. They were male. The dominant clinical symptom was headaches with consciousness disorder. Brain MRI allowed the diagnosis in all cases. The mean operation time was 100 minutes. A case of intraoperative hemorrhage was observed, necessitating the installation of an EDV. The outcome was favorable in two patients, and after surgery we observed one case of meningitis treated. One case of transient amnesia and one death were reported. Conclusion: Preliminary results of endoscopic treatment of colloid cysts were encouraging. It is a promising technique in our department. However, more investigation is necessary.

Spontaneous Enlargement then Regression of a Colloid Cyst of the III Ventricle

Aim: We describe a case of a 22 year old pregnant female patient who was found to have a small colloid cyst that increased spontaneously, followed by spontaneous significant reduction in size. Presentation of Case: The patient’s colloid cyst was picked up incidentally in late pregnancy at 39 weeks. It showed spontaneous increase in size accompanied by deterioration of symptoms at 31 months post diagnosis and then showed significant spontaneous reduction in size at 38 months post diagnosis. Discussion and Conclusion: Spontaneous reduction of a colloid cyst of third ventricle is a very rarely described phenomenon. To our knowledge this is one of only 3 cases of spontaneous regression of an III ventricular colloid cyst. It may be reasonable to follow up cases, where there is a documented history of increase.

Management of colloid cyst of third ventricle.

Colloid cysts are usually located in third ventricle and are believed to be derived from either primitive neuroepithelium or endoderm. Patients may remain asymptomatic for long time while some can present with paroxysmal headache, gait disturbance, nausea, vomiting, behavioral changes, weaknesses of lower limbs, impaired memory, new learning disability and sudden death. Computed tomography usually reveals a well-defined round or oval nonenhancing lesion. Although magnetic resonance imaging (MRI) signal intensity of colloid cysts is variable, the most common appearance is hyperintensity in T1-weighted sequences and iso to hypointensity in T2-weighted sequences. Observation, stereotactic aspiration, microscopic or endoscopic approaches and shunt surgery are various management options. Transcallosal and transcortical microscopic (with or without tubular retractor) approaches are mainly useful in normal-sized and dilated ventricles respectively. Endoscopic technique is an effective alternative to microsurgical technique but total resection and long-term recurrence remains a concern. Utilization of two instruments, the bi port technique and tubular retractor can be helpful in selected patients to overcome limitations. Although total excision should be aimed, subtotal excision and coagulation of residual cyst wall usually results in good long-term results without any growth of remnant wall. Conversion to an open procedure may be required in some patients.

Colloid cyst in third ventricle - a rare case

Colloid cyst in third ventricle - a rare case

Colloid Cyst Presenting as Recurrent Mania

Back to table of contents Next article LettersFull AccessColloid Cyst Presenting as Recurrent ManiaManjeet S. Bhatia, M.D., Shruti Srivastava, D.N.B., Anurag Jhanjee, M.D., and Anant Oberoi, M.B.B.S.Manjeet S. BhatiaSearch for more papers by this author, M.D., Shruti SrivastavaSearch for more papers by this author, D.N.B., Anurag JhanjeeSearch for more papers by this author, M.D., and Anant OberoiSearch for more papers by this author, M.B.B.S.Published Online:1 Jul 2013https://doi.org/10.1176/appi.neuropsych.11110352AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: A colloid cyst, also called a neuroepithelial cyst, is a slow-growing, benign tumor that occurs in the anterior third ventricle.1 Colloid cysts of the third ventricle represent 0.5%−2% of all intracranial tumors.2,3 The cyst typically blocks the foramen of Monro, causing obstructive hydrocephalus involving only the lateral ventricles. The common presenting symptoms are headache, nausea, vomiting, memory loss, mental status changes, gait disorder, insomnia, and visual disturbances.4 We report a case who presented with organic manic disorder, which remitted after the surgery.“Ms. N,” a 24-year-old, married woman presently working as a housewife, was referred from the neurosurgery ward to the Psychiatry outpatient department with chief complaints of abnormal behavior, seeing pictures/images of some man and animals, and feeling sensations as if someone is touching her for few seconds. The patient was apparently well 15 days ago, when she stopped taking care of her 10-month-old child, and mixed salt in the milk to be given to the child. She cleaned the house and then spread the dirt again. Also, in many instances, she would put clothes in to wash and then to dry without ever cleaning them. She had also been watching images of one man who was changing his body form into a lion that kept changing in size. Many times, she also saw something like an animal standing at the door of her house and trying to come inside her room. For the last 2 weeks, her mood had become highly elated. At times, she was spending money beyond her budget and developed features of overactivity, excessive talking, argumentativeness, extreme irritability, grandiosity, abusiveness, and decreased need for sleep. There was an increase in her appetite and decrease in sleep. Occasionally, she also felt restlessness and anxiety. There were no first-rank symptoms suggestive of schizophrenia. She had similar symptoms twice in the past, about 3 years and 6 years ago, with each lasting for about 15 days, without any treatment. Her personal and family history was noncontributory. CT scan showed a colloidal cyst in the brain, with obstructive hydrocephalus (Figure 1). She was started on haloperidol 10 mg/day and divalproex sodium 1,000 mg/day. She was operated on (Figure 2), after which there was remission of psychotic symptoms. Medication was discontinued after 3 months. On following her up for the last 6 months, she has not developed any symptoms. Surgical resection is the recommended treatment,2,5 as was done in the present case. After the surgery, there was remission of neuropsychiatric symptoms. This is the first case report of colloid cyst presenting with recurrent manic symptoms.FIGURE 1. Preoperative CT scanFIGURE 2. Postoperative CT scanDepartment of Psychiatry U.C.M.S. & G.T.B. Hospital Dilshad Garden, Delhi IndiaCorrespondence: Dr. M.S. Bhatia; e-mail: [email protected]comReferences1 Richards J, Ballard N: Colloid cyst: a case study. J Neurosurg Sci 2007; 51:53–60Medline, Google Scholar2 Acerbi F, Rampini P, Egidi M, et al.: Endoscopic treatment of colloid cyst of third ventricle: long-term results in a series of 6 consecutive cases. Minim Invasive Neurosurg 2007; 50:313–317Crossref, Medline, Google Scholar3 Hadley DM: Colloid cyst of the third ventricle. J Neurol Neurosurg Psychiatry 2002; 72(Suppl 2):ii15Medline, Google Scholar4 Lajara-Nanson WA: Neuropsychiatric manifestations of a third-ventricular colloid cyst. Am J Forensic Med Pathol 1980; 1:29–45Crossref, Medline, Google Scholar5 Stachura K, Libionka W, Moskała M, et al.: Colloid cysts of the third ventricle: endoscopic and open microsurgical management. Neurol Neurochir Pol 2009; 43:251–257Medline, Google Scholar FiguresReferencesCited byDetailsCited ByRight-sided brain lesions predominate among patients with lesional mania: evidence from a systematic review and pooled lesion analysis12 May 2020 | Translational Psychiatry, Vol. 10, No. 1Third ventricular colloid cyst and chronic mania22 January 2020 | Australian & New Zealand Journal of Psychiatry, Vol. 54, No. 4, Vol. 165Manic Episodes Due to Medical IllnessesJournal of Nervous & Mental Disease, Vol. 206, No. 9 Volume 25Issue 3 Summer 2013Pages E01-E02 Metrics PDF download History Published online 1 July 2013 Published in print 1 July 2013

Colloid cyst of third ventricle: A case report

Colloid cyst of the third ventricle is a rare congenital benign intracranial entity occurring in 0.5 – 3 % of primary brain tumors and 15 – 20 % of intraventricular ICSOLs. Symptoms include headache, memory loss, syncope, gait disturbances, lower limb weakness or urinary incontinence. Diagnosed incidentally or during MRI Brain for other reasons, can present with acute hydrocephalus, herniation and death. Various modalities exist forthe treatment including interhemispheric transcallosal approach, transcortical approach, endoscopic approach and stereotactic approach. All techniques have favorable and comparable outcomes. We present a case report and discussion about various open and endoscopic management options of the patients with colloid cysts.

Colloid Cyst of Third Ventricle: Unusual Cause of Headache

Colloid Cyst of Third Ventricle: Unusual Cause of Headache

083 What is the aetiology of thunderclap headache? A systematic review of the causes of acute severe headache

IntroductionA severe headache of abrupt onset without identifiable cause is termed Primary Thunderclap Headache. Cranial CT and CSF examination will exclude aneurysmal subarachnoid haemorrhage, but may not identify other causes....

Giant colloid cyst of third ventricle with microhemorrhages causing neurological deterioration: A very rare presentation

Giant colloid cyst of third ventricle with microhemorrhages causing neurological deterioration: A very rare presentation