Endoscopic Treatment of Colloid Cysts of the Third Ventricle:9 Consecutive Cases

The purpose of this study is to evaluate the efficacy of the endoscopic technique for the treatment of the colloid cysts of the third ventricle. Between August 1995 and October 1997 a series of nine patients with colloid cyst of the third ventricle (6 males and 3 females) were treated with this method. The technique, consisting of cyst fenestration, aspiration of the colloid, and coagulation of the internal layer of the wall, was always effective in restoring CSF circulation. Operating time was 54 - 120 min (median 67 min). We recorded only one post-operative septic complication but no signs of direct surgical morbidity. Post-operation hospital stay was 2 - 30 days (median 5 days). Follow up was 14 - 40 months (mean 27 months). We did not observe any clinical or radiological recurrence. Endoscopic treatment of colloid cysts of the third ventricle is a safe and effective alternative to the well-established approaches of microsurgical removal and stereotactic aspiration. Only a very long follow-up will answer the question of the long-term effectiveness of this method.

Key words:

Endoscopy - Colloid Cyst - Third Ventricle Tumor

References

• 1 Abernathey C D, Davis D H, Kelly P J. Treatment of colloid cysts of the third ventricle by stereotaxic microsurgical laser craniotomy.  J Neurosurg. 1989;  70 525-529
• 2 Byard R W, Moore L. Sudden and unexpected death in childhood due to a colloid cyst of the third ventricle.  J Forensic Sci. 1993;  38 210-213
• 3 Camacho A, Abernathey C D, Kelly P J, Laws Jr E R. Colloid cysts: experience with the management of 84 cases since the introduction of computed tomography.  Neurosurg. 1989;  24 693-700
• 4 Cabbell K S, Ross D A. Stereotactic microsurgical craniotomy for the treatment of third ventricular colloid cysts.  Neurosurg. 1996;  38 301-307
• 5 Cohen A R. Ventriculoscopic surgery.  Clin Neurosurg. 1994;  41 546-562
• 6 Decq P, Le Guerinel C, Brugieres P. et al . Endoscopic management of colloid cysts.  Neurosurg. 1998;  42 1288-1296
• 7 Deinsberger W, Boker D K, Samii M. Flexible endoscopes in treatment of colloid cysts of the third ventricle.  Minim Invas Neurosurg. 1994;  37 12-16
• 8 Gaab M R, Schroeder H WS. Neuroendoscopic approach to intraventricular lesions.  J Neurosurg. 1998;  88 496-505
• 9 Donauer E, Moringlane J R, Ostertag C B. Colloid cysts of third ventricle.  Acta Neurochir. 1986;  83 24-30
• 10 Garrido E, Fahs G R. Cerebral venous and sagittal sinus thrombosis after transcallosal removal of a colloid cyst of third ventricle.  Neurosurg. 1990;  26 540-542
• 11 Gokalp H Z, Yuceer N, Arasil E, Erdogan A, Dincer C, Baskaya M. Colloid cysts of the third ventricle.  Acta Neurochir. 1996;  138 45-49
• 12 Hall W A, Lunsford L D. Changing concepts in the treatment of colloid cysts.  J Neurosurg. 1987;  66 186-191
• 13 Hasegawa I, Fukushima T, Ihara T, Miyashita Y. Callosal window between prefrontal cortices: cognitive interaction to retrieve long-term memory.  Science. 1998;  281 814-818
• 14 Hodges J R, Carpenter K. Anterograde amnesia with fornix damage following removal of IIIrd ventricle colloid cyst.  J Neurol Neurosurg Psychiatry. 1991;  54 633-638
• 15 Kondziolka D, Lunsford L D. Stereotactic management of colloid cysts: factors predicting success.  J Neurosurg. 1991;  75 45-51
• 16 Kondziolka D, Lunsford L D. Stereotactic techniques for colloid cysts: role of aspiration, endoscopy and microsurgery.  Acta Neurochir. 1994;  (Suppl) 61 76-78
• 17 Lewis A I, Crone K R, Taha J. et al . Surgical resection of third ventricle colloid cysts.  J Neurosurg. 1994;  81 174-178
• 18 Maeder P P, Holtas S L, Basibuyuk L N, Salford L G, Tapper U AS, Brun A. Colloid cysts of the third ventricle: correlation of MR and CT findings with histology and chemical analysis.  AJNR. 1990;  11 575-581
• 19 Mathiesen T, Grane P, Lindgren L, Lindquist C, von Holst H. High recurrence rate following aspiration of colloid cysts in the third ventricle.  J Neurosurg. 1993;  78 748-752
• 20 Mathiesen T, Grane P, Lindgren L, Lindquist C. Third ventricle colloid cysts: a consecutive 12-years series.  J Neurosurg. 1997;  86 5-12
• 21 McMackin D, Cockburn J, Anslow P, Gaffan D. Correlation of fornix damage with memory impairment in six cases of colloid cysts removal.  Acta Neurochir. 1995;  135 12-18
• 22 Mohadjer M, Teshmar E, Mundinger F. CT-stereotaxis drainage of colloid cysts in the foramen of Monro and the third ventricle.  J Neurosurg. 1987;  67 220-223
• 23 Musolino A, Fosse S, Munari C, Daumas-Duport C, Chodkiewicz J P. Diagnosis and treatment of colloid cysts of the third ventricle by stereotactic drainage. Report on eleven cases.  Surg Neurol. 1989;  32 294-299
• 24 Powell M P, Torrens M J, Thomson J LG, Horgan J G. Isodense colloid cysts of the third ventricle: A diagnostic and therapeutic problem resolved by ventriculoscopy.  Neurosurg. 1983;  13 234-237
• 25 Ryder J W, Kleinschmidt-DeMasters B K, Keller T S. Sudden deterioration and death in patients with benign tumors of the third ventricle area.  J Neurosurg. 1986;  64 216-223
• 26 Zulch K J. (ed) .Brain Tumors: Their Biology and Pathology. Berlin: Springer-Verlag 1986
• 27 Samy Abdou M, Cohen A R. Endoscopic treatment of colloid cysts of the third ventricle: technical note and review of the literature.  J Neurosurg. 1998;  89 1062-1068

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