Surgical Management of a Colloid Cyst of third ventricle

Surgical Management of a Colloid Cyst of third ventricle

A 20-year-old girl, an art student, presented with two episodes of transient loss of consciousness lasting 20–30 minutes, accompanied by neck pain radiating to the left side. Clinical evaluation, followed by MRI, revealed a third ventricular colloid cyst, causing obstruction at the foramen of Monro and resulting in intermittent symptoms of raised intracranial pressure.

The patient underwent neuro-navigation-guided craniotomy and successful excision of the colloid cyst. Intraoperative and postoperative management were uneventful. The patient was extubated immediately following the procedure. A postoperative CT scan confirmed complete excision of the cyst, with no residual tumor visible.

She was monitored in the ICU for one day, where she demonstrated remarkable recovery. Impressively, she resumed her artistic pursuits on the first postoperative day, highlighting her swift neurological recovery. Currently, she is stable and recovering well in the ward.

We extend our gratitude to the entire neurosurgery team and the operating theater staff for their seamless coordination and dedication to achieving an excellent outcome for the patient.

This case underscores the importance of timely diagnosis, precise surgical planning, and multidisciplinary teamwork in the successful management of colloid cysts.

Histopathology- Nimhans 

Colloid cyst 

Regarding Third ventricular colloid cysts , these are rare 1 to 3 % whole intracranial tumours but potentially life-threatening intracranial lesions, often presenting a significant surgical challenge due to their deep midline location and proximity to critical neurovascular structures. These cysts can cause acute hydrocephalus and elevated intracranial pressure through obstruction of the foramen of Monro, leading to symptoms such as severe headaches, intermittent loss of consciousness, or, in rare cases, sudden death. Surgical management, either through neuro-navigation-guided craniotomy or endoscopic resection, demands meticulous planning and precise execution to minimize complications. Advances in neuro-navigation and microsurgical techniques have significantly enhanced the safety and efficacy of these procedures, making early diagnosis and prompt intervention essential in preventing catastrophic events.

Dr Ganesh Veerabhadraiah 
HOD and Senior Consultant Neurosurgeon
Kauvery hospital 
Electronic City
Bengaluru 

Ph no 7249669911

#ColloidCyst #ThirdVentricularTumours #BrainTumours #IntraventricularTumours #EndoscopicTumourRemoval #Craniotomy

How Hydrocephalus can cause problems in children?

The buildup of fluid in the cavities (ventricles) deep within the brain is known as hydrocephalus. The extra fluid expands the ventricles, which exerts pressure on the brain.

The brain and spinal column are generally bathed in cerebrospinal fluid, which circulates through the ventricles. However, excessive cerebrospinal fluid pressure associated with hydrocephalus can harm brain structures and result in a variety of symptoms.

Hydrocephalus can occur anyone at any age with depends on the  cause, however it is more common in infants and individuals aged 60 and up (normal pressure hydrocephalus). Hydrocephalus can be treated surgically to restore and maintain normal cerebrospinal fluid levels in the brain. Managing symptoms of functional deficits caused by hydrocephalus often necessitates a variety of interventions.

Symptoms of hydrocephalus:

The signs and symptoms of hydrocephalus differ depending on the age at which it first appears:

  • Infants

In babies, common indications and symptoms of hydrocephalus include:

Changes in head:

  •  A head that is exceptionally big.
  • A rise in the size of the head in a short period of time.
  • Fontanel on the top of the head

Physical signs and symptoms:

  •  Vomiting
  • Feeding problems
  • Seizures
  • Downward looking eyes (sunsetting of the eyes)
  • Muscle tone and strength deficiencies
  • Touch sensitivity is poor
  • Poor growth

Toddlers and older children:

Signs and symptoms in toddlers and older children may include:

Physical signs and symptoms:

  •  Headache
  • Double eyesight or hazy vision
  • Downward looking yes (sunsetting of eyes)
  • A toddler’s head is abnormally enlarged
  • Lethargy or sleepiness
  • Vomiting or nausea
  • Unstable equilibrium
  • Coordination issues
  • Appetite problems
  • Seizures
  • Urinary incontinence

Changes in behaviour and cognition:

  • Irritability
  • Personality shifts
  • School performance is declining
  • Delays or difficulties with previously learned tasks like walking or talking

Young and middle aged adults:

The signs and symptoms for this age group is as follows:

  • Headache
  • Lethargy
  • Urinary incontinence or a frequent urge to urinate
  • Vision impairment
  • Memory, focus and other thinking skills decline, which may have an impact on job performance

Older adults:

The following are the most prevalent indicators and symptoms of hydrocephalus in individuals aged 60 and above:

  • Urinary incontinence or a frequent urge to urinate
  • Loss of memory
  • Other thinking or reasoning skills gradually declining
  • Difficulty in walking, which is typically described as a shuffling stride or a stuck feeling in the feet
  • Coordination or balance issues

When to consult a doctor?

 For infants and toddlers who are experiencing the following signs and symptoms, seek emergency medical attention:

  • The sound of a high pitched scream or cry
  • Sucking or feeding difficulties
  • Recurrent, unexplained vomiting
  • A reluctance to move the head or lie down
  • Having trouble in breathing
  • Seizures

Causes of hydrocephalus:

An imbalance between the amount of cerebrospinal fluid produced and the amount absorbed into the bloodstream causes hydrocephalus.

Cerebrospinal fluid is produced by the tissues that line the brain’s ventricles. It travels through interconnected channels in the ventricles. The fluid eventually finds its way into the regions around the brain and spine. It is predominantly absorbed by the blood vessels.

Cerebrospinal fluid is vital for brain function because of the following reasons:

  • It Allows the comparatively hefty brain to float within the skull by keeping it buoyant
  • To protect the brain from harm, it is cushioned.
  • Getting rid of waste materials produced by the brain’s metabolism
  • Flowing back and forth between the brain cavity and the spinal column to maintain a constant pressure within the brain, correcting for fluctuations in blood pressure.

Complications:

 Long term hydrocephalus consequences can vary greatly and are frequently impossible to foresee. If hydrocephalus has advanced by the time a child is born, it can cause serious intellectual, developmental and physical impairments. Less severe instances may have few, if any, major sequelae if treated properly.

Adults who have had a considerable reduction in memory or other thinking skills have a slower recovery and more lasting problems after hydrocephalus therapy.

The severity of complications is determined by the following factors:

  • There may be underlying medical or developmental issues
  • Initial symptom severity
  • Diagnosis and treatment should be done as soon as possible

Summary: Neurowellness is a Bangalore Spine Specialist Clinic providing high quality brain and spine care at an inexpensive price. This center is one of the most cost effective and gives high quality treatment choices to the patients.

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