Colloid cysts of the third ventricle. Endoscopic and open microsurgical management.
OBJECTIVE
The endoscopic approach to colloid cysts of the third ventricle is receiving increasing interest. However, its effectiveness is a matter of discussion. The aim of the study was to present direct and long-term outcome after endoscopy of colloid cyst vs microsurgery.


METHODS
Medical records of 23 patients with colloid cysts were retrospectively analyzed. This group consists of 10 patients treated endoscopically and 13 patients treated using a transcortical-transventricular approach. Sex and age distributions were similar in both groups. Clinically, symptoms of raised intracranial pressure predominated. All patients had hydrocephalus. Tumour diameter ranged from 1.5 to 3 cm. Mean follow-up period was 31 months.


RESULTS
In 6/10 endoscopically treated patients, tumours were completely removed. In 3 patients, small capsule remnants, adherent to the choroid plexus and veins, were left. In one case, a portion of capsule, obstructing the intraventricular foramen, was finally removed microsurgically. Postoperatively, 2 patients complained of memory deficits, which became permanent in one case. One patient developed temporary mutism. In one case, with symptoms of hydrocephalus without colloid cyst recurrence, a ventriculoperitoneal shunt was implanted 6 months after the initial surgery. In all microsurgically treated patients tumours were completely removed. One patient was reoperated because of intracerebral haematoma. Two patients suffered from temporary hemiparesis and 2 developed epilepsy. Within one year after surgery 3 patients were shunted because of hydrocephalus; one patient required antiepileptic treatment.


CONCLUSIONS
The endoscopic approach to colloid cysts of the third ventricle is safe, effective and carries a low complication rate. Endoscopy may be recommended as a treatment option.
Stachura
Krzysztof
K
Department of Neurosurgery and Neurotraumatology, Jagiellonia University Medical College, Krakow. kkstach@poczta.onet.pl
Libionka
Witold
W
Moskała
Marek
M
Krupa
Mariusz
M
Polak
Jarosław
J
D000328:Adult; D020863:Central Nervous System Cysts / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D003102:Colloids / Q000032:analysis; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011044:Poland; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D020542:Third Ventricle / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
D003102:Colloids