title: Management outcome of the transcallosal, transforaminal approach to colloid cysts of the anterior third ventricle: an analysis of 78 cases.
abstract: BACKGROUND
  Colloid cysts are not common brain lesions and account for 0.2-2.0% of all brain lesions. Transcallosal, transforaminal approach is a safe route and the most direct path to excise third ventricular colloid cyst, without dependence on hydrocephalus.
  
  
  OBJECTIVE
  To assess the surgical outcome of patients with colloid cysts of the anterior third ventricle treated by the transcallosal, transforaminal approach.
  
  
  METHODS
  Seventy-eight patients operated by the above approach over a period of 20 years were analyzed. A pre- and postoperative neurological assessment was done in all the patients. Neuro-cognitive evaluation of corpus callosum function was done in the last 20 patients. Computer tomography scan of the brain was done in all patients pre- and postoperatively.
  
  
  RESULTS
  Clinical features of raised intracranial pressure without localizing signs were the commonest presenting feature in 52 (66.7%) patients. Hydrocephalus was present in 65 (83.3%) patients. All patients underwent the transcallosal, transforaminal approach, and total excision of the lesion was achieved in 77 patients and subtotal in 1. Four patients required a postoperative shunt for acute hydrocephalus. There was no incidence of postoperative disconnection syndrome. In two patients, there was recurrence of the lesion after 2 and 6 years, respectively. Two patients died in the postoperative period.
  
  
  CONCLUSIONS
  Colloid cyst is surgically curable. Early detection and total excision of the lesion can be a permanent cure with low mortality and minimum morbidity, when compared to the natural history of the disease. The limited anterior callosotomy does not result in disconnection syndromes or behavioral disturbance.
authors: Dr. A. Lakshmipathi Neurosurgical Centre, VHS Hospital, Chennai, India. nigelpetersymss@gmail.com
authors: Nigel Peter
authors: NP
authors: Symss
authors: Ravi
authors: R
authors: Ramamurthi
authors: Santosh Mohan
authors: SM
authors: Rao
authors: Madabushi C
authors: MC
authors: Vasudevan
authors: Pradeep Kumar
authors: PK
authors: Jain
authors: Anil
authors: A
authors: Pande
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002551:Cerebral Ventricle Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D056364:Colloid Cysts; D003337:Corpus Callosum / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000473:pathology / Q000601:surgery*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018302:Neoplasms, Neuroepithelial / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D012189:Retrospective Studies; D020542:Third Ventricle / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult