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Disorders of Circulation of the Cerebrospinal Fluid
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Colloid cysts are the most common cause of obstructing/noncommunicating hydrocephalus at the level of the foramen of Monro. In hydrocephalus due to colloid cysts, the lateral ventricles are variously enlarged depending on the severity of the stenosis and the compliance (stiffness) of the ventricles. The obstructive hydrocephalus may be intermittent and can increase in supine position. Colloid cysts that cause hydrocephalus may present at any age, but typical patient is a young adult e.g. 20–40 years of age. Confounding the diagnosis is that about half of all colloid cysts are discovered in asymptomatic patients for which imaging was obtained.
Neurosurgical Techniques and Strategies
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Jonathan E. Martin, Ian F. Pollack, Robert F. Keating
The transventricular endoscopic approach provides a minimally invasive means of approaching pathology of the anterior third ventricle (Figure 6.11). The surgeon employs a frontal burr hole to access the lateral ventricle, allowing for navigation to the foramen of Monro with the endoscope.35 Indications include tumor biopsy, and resection of select pathology such as colloid cysts.
How to plan for specific scenarios
Published in Vivian A. Elwell, Ramez Kirollos, Syed Al-Haddad, Neurosurgery, 2014
Vivian A. Elwell, Ramez Kirollos, Syed Al-Haddad
Demonstrate your knowledge regarding the over-all management of incidental colloid cysts. This should include the accepted recommendation for treatment if the colloid cyst is symptomatic, >10 mm in size, and located high in the septum pellucidum or in the roof of the third ventricle. Sudden death due to a colloid cyst is rare but an important consideration. Discuss the significance of the presence or absence of hydrocephalus in selecting a surgical approach. Safety is the major key issue; do not underestimate the morbidity (including memory impairment) and mortality following transcallosal surgery.
A rare case of intralesional haemorrhage of a benign aqueductal cyst after CSF diversion treatment. A case report and review of literature
Published in British Journal of Neurosurgery, 2023
R. D. Biju, J. O’ Sullivan, A. Thomas, P. Gan, T. Muthu
The natural history of benign ventricular cysts is poorly understood.5,6 Colloid cysts are rare, representing about 0.5–1% of all intracranial tumours.7,8 Preferentially encountered within the third ventricle, other locations have been reported including the fourth ventricle, suprasellar region, cerebellum and rarely, within the cerebral aqueduct.9 They are not typically vascular in nature, making intracystic haemorrhage a rare phenomenon. About 21 cases have been reported in literature worldwide, 4 of which were at post-mortem.10,11 Cuoco et al. hypothesized that an exercise-induced rise in systolic blood pressure contributed to the phenomena in their 21-year-old patient.12 Spontaneous intracystic haemorrhage in pineal cysts is a well-documented phenomenon. Tamura et al. described its occurrence in their patient who commenced antiplatelet treatment for stroke.13,14
First reported case of hydrocephalus in jointly diagnosed bacterial meningitis and a colloid cyst: how Ockham’s razor became Hickam’s dictum
Published in British Journal of Neurosurgery, 2022
Gareth May, Simon Lammy, Aditaya Kumar, Ajay Hegde, Edward Jerome St. George
A colloid cyst is a benign intracranial lesion which accounts for 0.5 − 3.0% of primary brain neoplasms.1 Most are asymptomatic and arise in the anterior aspect of the third ventricle. Its proximity to the interventricular foramen of Munro can cause obstructive hydrocephalus which may result in coma and death if left untreated.2 Although symptomatic colloid cysts often present due to symptoms of raised intracranial pressure (ICP),3 rare cases of aseptic meningitis have been reported secondary to extravasation of cyst contents.4 Our case highlights how the quest for diagnostic parsimony resulted in our patient being diagnosed with a symptomatic colloid cyst (Ockham’s razor).5 However, subsequent blood and cerebrospinal fluid (CSF) cultures grew Streptococcus pneumoniae. The ensuing diagnostic uncertainty to the actual cause of his hydrocephalus reflects the importance of Hickam’s dictum,6 “a man can have as many diseases as he damn well pleases.” And in our post-modern society any human being can have as many diseases as they damn well please.
Endoscopic versus open microsurgery for colloid cysts of the third ventricle
Published in British Journal of Neurosurgery, 2023
Dan Farahmand, Johannes Stridh, Doerthe Ziegelitz, Magnus Tisell
The diagnosis of colloid cyst was confirmed by pathology in 44 (86%) patients. In the cases where the histopathological report was missing (5 in the OS group and 2 in the ES group), the diagnosis was based on the combination of radiographic and intraoperative findings.