Third ventricle colloid cysts: a consecutive 12-year series

Tiit Mathiesen M.D., Ph.D. 1 , Per Grane M.D. 1 , Lars Lindgren M.D. 1 , and Christer Lindquist M.D., Ph.D. 1
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  • 1 Departments of Neurosurgery and Neuroradiology, Karolinska Hospital, Stockholm, Sweden
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✓ A continuous follow-up review of colloid cysts including aspects of natural history and evaluation of treatment options is necessary to optimize individual treatment. Thirty-seven consecutive patients with colloid cyst of the third ventricle seen at Karolinska Hospital between 1984 and 1995 were reviewed. Five patients were admitted in a comatose state, and two died despite emergency ventriculostomy. Three had recurrent cysts following previous aspiration procedure. During the study period, patients underwent a total of 10 ventriculostomies, 10 aspirations, 26 microsurgical operations, and two shunt operations.

Twenty-four of 26 microsurgical operations were transcallosal and two were transcortical. Twenty-four operations (22 transcallosal and two transfrontal approaches) without permanent morbidity were performed by four surgeons. Transient memory deficit from forniceal traction was noted in 26%. The remaining two transcallosal operations, which led to permanent morbidity or mortality, were performed by two different surgeons. Aspiration of cysts performed by four different surgeons carried a 40% risk of transient memory deficit (10% permanent) and an 80% recurrence rate. One patient was found to be cured on radiological studies obtained at the 5-year follow-up review.

Seven cysts were followed by means of radiological studies with no treatment for 6 to 37 months. Five of these cysts grew, indicating that younger patients with colloid cysts will probably need surgical treatment.

The main causes of unfavorable results were: 1) failure to investigate symptoms that proved fatal; 2) subtotal resection; and 3) surgical complications. Transcallosal microsurgery produced excellent results when performed by experienced surgeons. A colloid cyst of the foramen of Monro is a disease that should be detected before permanent neurological damage has occurred. Permanent morbidity or mortality should not be accepted in modern series of third ventricle colloid cysts.

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Address reprint requests to: Tiit Mathiesen, M.D., Karolinska Hospital, S-171 76 Stockholm, Sweden.
  • 1.

    Abernathey CD, , Davis DH, & Kelly PJ: Treatment of colloid cysts of the third ventricle by stereotaxic microsurgical laser craniotomy. J Neurosurg 70:525529, 1989 Abernathey CD, Davis DH, Kelly PJ: Treatment of colloid cysts of the third ventricle by stereotaxic microsurgical laser craniotomy. J Neurosurg 70:525–529, 1989

    • Search Google Scholar
    • Export Citation
  • 2.

    Antunes JL, , Louis KM, & Ganti SR: Colloid cysts of the third ventricle. Neurosurgery 7:450455, 1980 Antunes JL, Louis KM, Ganti SR: Colloid cysts of the third ventricle. Neurosurgery 7:450–455, 1980

    • Search Google Scholar
    • Export Citation
  • 3.

    Bengtson BP, , Hedeman LS, & Bauserman SC: Symptomatic neuroepithelial (colloid) cysts of the third ventricle. A unique case report in nontwin brothers. Cancer 66:779785, 1990 Bengtson BP, Hedeman LS, Bauserman SC: Symptomatic neuroepithelial (colloid) cysts of the third ventricle. A unique case report in nontwin brothers. Cancer 66:779–785, 1990

    • Search Google Scholar
    • Export Citation
  • 4.

    Black P, & Ojemann RG: Hydrocephalus in adults, in Youmans JR (ed): Neurological Surgery. Philadelphia: WB Saunders, 1990, pp 12771298 Black P, Ojemann RG: Hydrocephalus in adults, in Youmans JR (ed): Neurological Surgery. Philadelphia: WB Saunders, 1990, pp 1277–1298

    • Search Google Scholar
    • Export Citation
  • 5.

    Bosch DA, , Rähn T, & Backlund EO: Treatment of colloid cysts of the third ventricle by stereotactic aspiration. Surg Neurol 9:1518, 1978 Bosch DA, Rähn T, Backlund EO: Treatment of colloid cysts of the third ventricle by stereotactic aspiration. Surg Neurol 9:15–18, 1978

    • Search Google Scholar
    • Export Citation
  • 6.

    Brun A, & Egund N: The pathogenesis of cerebral symptoms in colloid cysts of the third ventricle: a clinical and pathoanatomical study. Acta Neurol Scand 49:525535, 1973 Brun A, Egund N: The pathogenesis of cerebral symptoms in colloid cysts of the third ventricle: a clinical and pathoanatomical study. Acta Neurol Scand 49:525–535, 1973

    • Search Google Scholar
    • Export Citation
  • 7.

    Caemart J, & Calliauw L: Surgical techniques in the management of colloid cysts of the third ventricle. A note on the use of a modern endoscope. Adv Tech Stand Neurosurg 17:149153, 1990 Caemart J, Calliauw L: Surgical techniques in the management of colloid cysts of the third ventricle. A note on the use of a modern endoscope. Adv Tech Stand Neurosurg 17:149–153, 1990

    • Search Google Scholar
    • Export Citation
  • 8.

    Cairns H, & Mosberg WH Jr: Colloid cyst of the third ventricle. Surg Gynecol Obstet 92:545568, 1951 Cairns H, Mosberg WH Jr: Colloid cyst of the third ventricle. Surg Gynecol Obstet 92:545–568, 1951

    • Search Google Scholar
    • Export Citation
  • 9.

    Camacho A, , Abernathey CD, & Kelly PJ, et al: Colloid cysts: experience with the management of 84 cases since the introduction of computerized tomography. Neurosurgery 24:693700, 1989 Camacho A, Abernathey CD, Kelly PJ, et al: Colloid cysts: experience with the management of 84 cases since the introduction of computerized tomography. Neurosurgery 24:693–700, 1989

    • Search Google Scholar
    • Export Citation
  • 10.

    Cameron AS, & Archibald YM: Verbal memory deficit after left fornix removal. Int J Neurosci 12:201, 1981 Cameron AS, Archibald YM: Verbal memory deficit after left fornix removal. Int J Neurosci 12:201, 1981

    • Search Google Scholar
    • Export Citation
  • 11.

    Carmel PW: Tumours of the third ventricle. Acta Neurochir 75:136146, 1985 Carmel PW: Tumours of the third ventricle. Acta Neurochir 75:136–146, 1985

    • Search Google Scholar
    • Export Citation
  • 12.

    Cetinalp E, , Ildan F, & Boyar B, et al: Colloid cysts of the third ventricle. Neurosurg Rev 17:135139, 1994 Cetinalp E, Ildan F, Boyar B, et al: Colloid cysts of the third ventricle. Neurosurg Rev 17:135–139, 1994

    • Search Google Scholar
    • Export Citation
  • 13.

    Dandy WE: Benign Tumors of the Third Ventricle of the Brain: Diagnosis and Treatment. Springfield, Ill: Charles C Thomas, 1933, p 171 Dandy WE, Benign Tumors of the Third Ventricle of the Brain: Diagnosis and Treatment. Springfield, Ill: Charles C Thomas, 1933, p 171

    • Search Google Scholar
    • Export Citation
  • 14.

    Deinsberger W, , Böker DK, & Bothe HW, et al: Stereotactic endoscopic treatment of colloid cysts of the third ventricle. Acta Neurochir 131:260264, 1994 Deinsberger W, Böker DK, Bothe HW, et al: Stereotactic endoscopic treatment of colloid cysts of the third ventricle. Acta Neurochir 131:260–264, 1994

    • Search Google Scholar
    • Export Citation
  • 15.

    Deinsberger W, , Böker DK, & Samii M: Flexible endoscopes in treatment of colloid cysts of the third ventricle. Minim Invasive Neurosurg 37:1216, 1994 Deinsberger W, Böker DK, Samii M: Flexible endoscopes in treatment of colloid cysts of the third ventricle. Minim Invasive Neurosurg 37:12–16, 1994

    • Search Google Scholar
    • Export Citation
  • 16.

    Dott NM: Surgical aspects of the hypothalamus, in Clark WEL, , Beattie J, & Riddoch G, et al (eds): The Hypothalamus: Morphological, Functional, Clinical and Surgical Aspects. Edinburgh: Oliver and Boyd, 1938, pp 131185 Dott NM, Surgical aspects of the hypothalamus, in Clark WEL, Beattie J, Riddoch G, et al (eds): The Hypothalamus: Morphological, Functional, Clinical and Surgical Aspects. Edinburgh: Oliver and Boyd, 1938, pp 131–185

    • Search Google Scholar
    • Export Citation
  • 17.

    Fritsch H: Colloid cysts—a review including 19 own cases. Neurosurg Rev 11:159166, 1988 Fritsch H: Colloid cysts—a review including 19 own cases. Neurosurg Rev 11:159–166, 1988

    • Search Google Scholar
    • Export Citation
  • 18.

    Geffen G, , Walsh A, & Simpson D, et al: Comparison of the effects of transcortical and transcallosal removal of intraventricular tumours. Brain 103:773788, 1980 Geffen G, Walsh A, Simpson D, et al: Comparison of the effects of transcortical and transcallosal removal of intraventricular tumours. Brain 103:773–788, 1980

    • Search Google Scholar
    • Export Citation
  • 19.

    Greenwood J Jr: Paraphysial cysts of the third ventricle. With report of eight cases. J Neurosurg 6:153159, 1949 Greenwood J Jr: Paraphysial cysts of the third ventricle. With report of eight cases. J Neurosurg 6:153–159, 1949

    • Search Google Scholar
    • Export Citation
  • 20.

    Gutierrez-Lara F, , Patiño R, & Hakim S: Treatment of tumors of the third ventricle: a new and simple technique. Surg Neurol 3:323325, 1975 Gutierrez-Lara F, Patiño R, Hakim S: Treatment of tumors of the third ventricle: a new and simple technique. Surg Neurol 3:323–325, 1975

    • Search Google Scholar
    • Export Citation
  • 21.

    Hall WA, & Lunsford LD: Changing concepts in the treatment of colloid cysts. An 11-year experience in the CT era. J Neurosurg 66:186191, 1987 Hall WA, Lunsford LD: Changing concepts in the treatment of colloid cysts. An 11-year experience in the CT era. J Neurosurg 66:186–191, 1987

    • Search Google Scholar
    • Export Citation
  • 22.

    Hodges JR, & Carpenter K: Anterograde amnesia with fornix damage following removal of IIIrd ventricle colloid cyst. J Neurol Neurosurg Psychiatry 54:633638, 1991 Hodges JR, Carpenter K: Anterograde amnesia with fornix damage following removal of IIIrd ventricle colloid cyst. J Neurol Neurosurg Psychiatry 54:633–638, 1991

    • Search Google Scholar
    • Export Citation
  • 23.

    Ibrahim AWM, , Farag H, & Naguib M, et al: Neuroepithelial (colloid) cyst of the third ventricle in identical twins. Case report. J Neurosurg 65:401403, 1986 Ibrahim AWM, Farag H, Naguib M, et al: Neuroepithelial (colloid) cyst of the third ventricle in identical twins. Case report. J Neurosurg 65:401–403, 1986

    • Search Google Scholar
    • Export Citation
  • 24.

    Jeeves MA, , Simpson DA, & Geffen G: Functional consequences of the transcallosal removal of intraventricular tumours. J Neurol Neurosurg Psychiatry 42:143142, 1979 Jeeves MA, Simpson DA, Geffen G: Functional consequences of the transcallosal removal of intraventricular tumours. J Neurol Neurosurg Psychiatry 42:143–142, 1979

    • Search Google Scholar
    • Export Citation
  • 25.

    Jennett B, & Teasdale G: Management of Head Injuries. Philadelphia: FA Davis, 1981, pp 7193 Jennett B, Teasdale G: Management of Head Injuries. Philadelphia: FA Davis, 1981, pp 71–93

    • Search Google Scholar
    • Export Citation
  • 26.

    Kondziolka D, & Lunsford LD: Stereotactic management of colloid cysts: factors predicting success. J Neurosurg 75:4551, 1991 Kondziolka D, Lunsford LD: Stereotactic management of colloid cysts: factors predicting success. J Neurosurg 75:45–51, 1991

    • Search Google Scholar
    • Export Citation
  • 27.

    Levin HS, , Mattson AJ, & Levander M, et al: Effects of transcallosal surgery on interhemispheric transfer of information. Surg Neurol 40:6574, 1993 Levin HS, Mattson AJ, Levander M, et al: Effects of transcallosal surgery on interhemispheric transfer of information. Surg Neurol 40:65–74, 1993

    • Search Google Scholar
    • Export Citation
  • 28.

    Lewis AI, , Crone KR, & Taha J, et al: Surgical resection of third ventricle colloid cysts. J Neurosurg 81:174178, 1994 Lewis AI, Crone KR, Taha J, et al: Surgical resection of third ventricle colloid cysts. J Neurosurg 81:174–178, 1994

    • Search Google Scholar
    • Export Citation
  • 29.

    Little JR, & MacCarty CS: Colloid cysts of the third ventricle. J Neurosurg 40:230235, 1974 Little JR, MacCarty CS: Colloid cysts of the third ventricle. J Neurosurg 40:230–235, 1974

    • Search Google Scholar
    • Export Citation
  • 30.

    Macdonald RL, , Humphreys RP, & Rutka JT, et al: Colloid cysts in children. Pediatr Neurosurg 20:169177, 1994 Macdonald RL, Humphreys RP, Rutka JT, et al: Colloid cysts in children. Pediatr Neurosurg 20:169–177, 1994

    • Search Google Scholar
    • Export Citation
  • 31.

    Mathiesen T, , Grane P, & Lindquist C, et al: High recurrence rate following aspiration of colloid cysts in the third ventricle. J Neurosurg 78:748752, 1993 Mathiesen T, Grane P, Lindquist C, et al: High recurrence rate following aspiration of colloid cysts in the third ventricle. J Neurosurg 78:748–752, 1993

    • Search Google Scholar
    • Export Citation
  • 32.

    Mathiesen T, , Lindquist C, & Kihlström L: Primary experience with the Steiner-Lindquist microsurgical guide for deep intraaxial lesions. Br J Neurosurg 10:155160, 1996 Mathiesen T, Lindquist C, Kihlström L: Primary experience with the Steiner-Lindquist microsurgical guide for deep intraaxial lesions. Br J Neurosurg 10:155–160, 1996

    • Search Google Scholar
    • Export Citation
  • 33.

    McKissock W: The surgical treatment of colloid cysts of the third ventricle. A report based upon twenty-one personal cases. Brain 74:19, 1951 McKissock W: The surgical treatment of colloid cysts of the third ventricle. A report based upon twenty-one personal cases. Brain 74:1–9, 1951

    • Search Google Scholar
    • Export Citation
  • 34.

    Mohadjer M, , Teshmar E, & Mundinger F: CT-stereotaxic drainage of colloid cysts in the foramen of Monro and the third ventricle. J Neurosurg 67:220223, 1987 Mohadjer M, Teshmar E, Mundinger F: CT-stereotaxic drainage of colloid cysts in the foramen of Monro and the third ventricle. J Neurosurg 67:220–223, 1987

    • Search Google Scholar
    • Export Citation
  • 35.

    Musolino A, , Fosse S, & Munari C, et al: Diagnosis and treatment of colloid cysts of the third ventricle by stereotactic drainage. Report on eleven cases. Surg Neurol 32:294299, 1989 Musolino A, Fosse S, Munari C, et al: Diagnosis and treatment of colloid cysts of the third ventricle by stereotactic drainage. Report on eleven cases. Surg Neurol 32:294–299, 1989

    • Search Google Scholar
    • Export Citation
  • 36.

    Nitta M, & Symon L: Colloid cysts of the third ventricle. A review of 36 cases. Acta Neurochir 76:99104, 1985 Nitta M, Symon L: Colloid cysts of the third ventricle. A review of 36 cases. Acta Neurochir 76:99–104, 1985

    • Search Google Scholar
    • Export Citation
  • 37.

    Powell MP, , Torrens MJ, & Thomson JLG, et al: Isodense colloid cysts of the third ventricle: a diagnostic and therapeutic problem resolved by ventriculoscopy. Neurosurgery 13:234237, 1983 Powell MP, Torrens MJ, Thomson JLG, et al: Isodense colloid cysts of the third ventricle: a diagnostic and therapeutic problem resolved by ventriculoscopy. Neurosurgery 13:234–237, 1983

    • Search Google Scholar
    • Export Citation
  • 38.

    Rivas JJ, & Lobato RD: CT-assisted stereotaxic aspiration of colloid cysts of the third ventricle. J Neurosurg 62:238242, 1985 Rivas JJ, Lobato RD: CT-assisted stereotaxic aspiration of colloid cysts of the third ventricle. J Neurosurg 62:238–242, 1985

    • Search Google Scholar
    • Export Citation
  • 39.

    Ryder JW, , Kleinschmidt-De Masters BK, & Keller TS: Sudden deterioration and death in patients with benign tumours of the third ventricle area. J Neurosurg 64:216223, 1986 Ryder JW, Kleinschmidt-De Masters BK, Keller TS: Sudden deterioration and death in patients with benign tumours of the third ventricle area. J Neurosurg 64:216–223, 1986

    • Search Google Scholar
    • Export Citation
  • 40.

    Shuangshoti S, & Netsky MG: Neuroepithelial (colloid) cysts of the nervous system. Further observations on pathogenesis, location, incidence, and histochemistry. Neurology 16:887903, 1966 Shuangshoti S, Netsky MG: Neuroepithelial (colloid) cysts of the nervous system. Further observations on pathogenesis, location, incidence, and histochemistry. Neurology 16:887–903, 1966

    • Search Google Scholar
    • Export Citation
  • 41.

    Shucart WA, & Stein BM: Transcallosal approach to the anterior ventricular system. Neurosurgery 3:339343, 1978 Shucart WA, Stein BM: Transcallosal approach to the anterior ventricular system. Neurosurgery 3:339–343, 1978

    • Search Google Scholar
    • Export Citation
  • 42.

    Sweet WH, , Talland GA, & Ervin FR: Loss of recent memory following section of fornix. Trans Am Neurol Assoc 84:7682, 1959 Sweet WH, Talland GA, Ervin FR: Loss of recent memory following section of fornix. Trans Am Neurol Assoc 84:76–82, 1959

    • Search Google Scholar
    • Export Citation
  • 43.

    Zülch KJ (ed): Brain Tumors. Their Biology and Pathology. Berlin: Springer-Verlag, 1986 Zülch KJ (ed): Brain Tumors. Their Biology and Pathology. Berlin: Springer-Verlag, 1986

    • Search Google Scholar
    • Export Citation

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