NeoplasmSurgical management of colloid cyst of the third ventricle—a study of 105 cases
Section snippets
Material and method
We analyzed 105 cases of third ventricle colloid cyst managed in our department between 1967 and 1998. The clinical records, radiological findings, and operative and follow-up notes were studied retrospectively.
In the pre-CT scan era, pneumoventriculograms, ventriculograms, and angiograms were done. After 1982, CT or MRI were performed in all patients. Based on the maximum diameter as measured on the CT or MRI scans, the colloid cysts were divided into three categories—small (<1.5 cm), medium
Clinical features
The male to female ratio was 1.5:1. The age ranged from 10 to 68 years with 64.8% of patients in the third and fourth decades (Table 2). The duration of clinical complaints at the time of presentation varied from 1 week to 4 years with an average of 8 months. Headache was the most prominent clinical symptom, occurring in 92.3% of patients. It was generalized, intermittent, and was often accompanied by blurred vision and vomiting. Variation in the intensity of headaches with change of posture
Discussion
Colloid cysts have provoked interest in neurosurgeons because of their controversial origin, benign histology, often dramatic clinical presentation, and the variety of possible treatment options 21, 53, 76, 89. Mathiesen et al [61] and Nitta and Symon [67] documented male sex predominance, as noted in our series. Camacho et al found no sex difference in their large series from Mayo Clinic [16]. There was no specific age group predominance in any of these series; however, in our series 64.7% of
Conclusions
Our experience has led us to the conclusion that the transcallosal route can be used safely to excise third ventricular colloid cysts. There are no permanent deficits in memory or intellectual function because of the limited callostomy and forniceal handling. Patients harboring large cysts and presenting in a comatose state carry a poor prognosis and high mortality rate. Ventriculoperitoneal shunts are not necessary for the management of the hydrocephalus. The hydrocephalus resolves completely
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2023, World NeurosurgeryCitation Excerpt :The approach for resection varies across centers; however, there is no consensus on whether the transcortical or the transcallosal approach should be used.8 Increased postoperative seizure rates have been described when using the transcortical approach,12,13 as well as higher numbers of wound infections, whereas endoscopic resections were associated with more residual cysts, as well as an increased incidence of ventriculitis/meningitis.2,8 Although short-term memory loss is a well-known complication of transcallosal microsurgery, postoperative persistent or worsened memory deficits have been described for all surgical approaches,2,8,14 including the less common infratentorial-supracerebellar resections.15
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