Romanian Neurosurgery (Mar 2011)
Our policy in intraventricular colloid cysts
Abstract
The colloid cyst of the third ventricle is a benign tumor situated in the anterior part of the third ventricle. This lesion represents less than 1% of the primary brain tumor being more common in young adults. Because of its particular location, the colloid cyst can obstruct the Monro foramen, producing intermittent intracranian hypertension with headache, vomiting and visual disturbances. Thirty-one cases of colloid cysts have been operated using the microsurgical approach in the First Neurosurgical Department of Emergency Clinical Hospital “Bagdasar-Arseni” between January 1995 and December 2008. The age of the patients was between 17 and 46 years, with a medium age of 31 years. The follow-up period was between 9 months and 7 years. In three cases TTA approach has been performed. One of the cases developed a venous cerebral infarct after this procedure, but the patient had finally a good outcome. For 28 patients the transcortical approach has been performed. In all cases the total resection of the colloid cyst has been performed. Of all 31 cases, one case presented a transitory hemiparesis, two cases showed negativist behavior, and three cases had transitory memory disturbances. There was no intraventricular hemorrhage after colloid cyst resection in our series. In conclusion, according to our policy, the microsurgical approach is the best treatment for third ventricular colloid cysts because of its main advantages compared with the endoscopic approach: the possibility of total resection of the cyst, the good control of the bleeding source during the procedure, and a better exposure of the anatomical landmarks.
