Ventricular Colloid Cysts Research Articles

Stereotactic microsurgical craniotomy for the treatment of third ventricular colloid cysts.

The treatment of colloid cysts remains controversial. This article reports on 18 patients with colloid cysts of the third ventricle who presented to the University of Michigan between January 1990 and June 1995. Two patients had conventional transcortical-transventricular approaches; the remaining 16 patients underwent a stereotactic modification of the transcortical approach, using a specially designed cylindrical retractor, for the resection of their colloid cysts. Minor morbidity and no mortality have been associated with this technique. There have been no instances of recurrence during the period of this report. The mean operative time for the two conventional craniotomies was 233 minutes, compared with 129 minutes for the stereotactic craniotomies. Our technique allows for a limited craniotomy and limited cortical disruption. It is not dependent on ventricular size. Localization of the colloid cyst is trivial because of modern stereotactic technology, and all standard microsurgical techniques can be used. The retractor is readily adaptable to any Leksell system. This technique shortens operative time, compared with conventional craniotomy, and allows for definitive treatment of the lesion.

Management outcome in third ventricular colloid cysts in a defined population: a series of 40 patients treated mainly by transcallosal microsurgery.

Third ventricular colloid cysts account for 0.5% - 1.5% of all intracranial tumors. A thorough search of the world literature since 1858 revealed 1167 cases, for which a more than one-third (36%) management mortality was estimated. One third of the reported cases had modern diagnostics and surgery with minimal morbidity and nearly no mortality. The primary goal of this study was to assess the incidence and present-day management outcome of these lesions in the strictly defined area of Eastern Finland. In a series of 2000 patients with brain tumors from our catchment area (870,000 inhabitants in eastern Finland) during a 14.5-year period (years 1980-1994), 40 patients (mean age, 45 years; range, 19-75 years, with 21 females) had a third ventricular colloid cyst. Thirty-one patients had transcallosal extirpation of their cysts. One additional tumor was extirpated by the infratentorial supracerebellar route to include simultaneous biopsy of a tectal tumor (lipoma). One elderly male with severe cardiac disease received a ventriculoatrial shunt. Five patients, admitted deeply unconscious, died. In two of these five patients, desperate shunting operations were done, but, in the remaining three moribund patients, no treatment was considered to be of any benefit. Two patients with small tumors are being followed up. The far lateral transcallosal transforaminal extirpation of the cyst has served our patients well. There was no surgical mortality. The outcome was excellent in 30 patients and good in 3 patients. Follow-up time ranged from 2 months to 14.5 years (mean, 4.3 years). There were no tumor recurrences. Despite good surgical results, management mortality was as high as 13%, The incidence of third ventricular colloid cysts is at least 3.2/1 million/1 year. Even nowadays, up to one fifth of these completely benign and treatable tumors are detected too late, with calamitous consequences.

Colloid cysts of the third ventricle: fatal outcomes associated with unusual presentation

It is always unfortunate when benign, surgically removable lesions cause unnecessary death. In three of five cases of third ventricular colloid cyst the patients presented with or developed severe headache which was like no other they had experienced before. The headache was of long enough duration to enable detection and removal of the cyst before its fatal outcome. In one case involving a fight it was considered that the third vetricular colloid cyst played an important part in the fatal outcome. In the fifth case the patient was found dead in bed without any preceding history of illness.

Colloid cysts of the third ventricle: an immunohistochemical study.

Eleven colloid cysts of the third ventricle were investigated by immunohistochemistry using 16 mono- and polyclonal antibodies. Colloid cyst epithelium, choroid plexus epithelium and ependyma showed different immunohistochemical profiles. In particular, antibodies to different cytokeratins and to transthyretin revealed considerable and constant differences of immunoreactivity. Therefore, common derivation of the three tissues seems unlikely. Our findings are interpreted in favour of the non-neuroepithelial origin of third ventricular colloid cysts.

Initial experience related to the use of the Cosman-Roberts-Wells stereotactic instrument

Initial experience with a new arc-radius design of stereotactic frame that interfaced with the existing components of the Brown-Roberts-Wells instrument is reported. Over a 6-month period, 32 procedures were performed on 23 males and nine female patients (mean age 32 years); these included 27 stereotactic biopsy procedures, two stereotactic implantations of cyst catheter reservoirs, two ventriculoscopic aspirations of third ventricular colloid cysts, and one stereotactic aspiration of a craniopharyngioma. In all cases successful targeting was achieved and verified by postoperative computerized tomography. There were no operation-related complications. This new frame offers rapid and accurate targeting and is a useful adjunct to the stereotactic armamentarium.

Behavioural manifestations of third ventricular colloid cysts

Behavioural manifestations of third ventricular colloid cysts

Behavioural manifestations of third ventricular colloid cysts: J.M. Lobosky, J.C. Vangidler, and A.R. Damasio. J Neurol Neurosurg Psych 1075–1080, (October), 1984

Behavioural manifestations of third ventricular colloid cysts: J.M. Lobosky, J.C. Vangidler, and A.R. Damasio. J Neurol Neurosurg Psych 1075–1080, (October), 1984

Third ventricular colloid cysts presenting with acute neurological deterioration

Colloid cysts may be found in any part of the third ventricle. The authors report that four out of 12 patients with colloid cysts of the third ventricle suffered acute neurological deterioration, and unilateral ventriculostomy resulted in dramatic recovery in two patients. Unilateral ventriculostomy followed by clinical assessment and computed tomographic scanning is an acceptable approach in emergency situations; computed tomographic scanning allows early detection of third ventricular colloid cysts. Ventriculoperitoneal shunting provides a laternative measure to surgical removal of the cyst. Definitive management soon after diagnosis and before acute neurological deterioration is recommended. The cases presenting with sudden death in the literature are reviewed.

Thin-section computed tomography in the evaluation of third ventricular colloid cysts.

The computed tomographic (CT) scan findings in 4 cases of third ventricular colloid cyst are presented, and the importance of thin-section CT in the evaluation of this lesion is discussed. Overlapping 8-mm sections are helpful in differentiating normal vasculature adjacent to the foramen of Monro from a third ventricular colloid cyst.

TEST TYPES

Acute bleeding within a colloid cyst of the third ventricle represents a rare event causing sudden increase in the cyst volume that may lead to acute hydrocephalus and rapid neurological deterioration. We report a case of spontaneous rupture of haemorrhagic third ventricular colloid cyst and its management. A 77-year-old ex-smoker presented with unsteady gait, incontinence and gradually worsening confusion over a 3-week period. Brain CT scan findings were highly suggestive of a third ventricular colloid cyst with intraventricular rupture. He underwent cyst excision and histopathology, which confirmed the radiological diagnosis with evidence of haemorrhage within the cyst. A ventriculo peritoneal shunt was performed for delayed hydrocephalus. Surgical management of these patients must include emergency ventriculostomy followed by prompt surgical removal of the haemorrhagic cyst.