Microsurgical Treatment of Colloid Cysts of the Third Ventricle

Highlights • The transcallosal approach allows for a radical third ventricle colloid cyst resection with a minimal complication rate. • The supracerebellar infratentorial approach helpful when hydrocephalus is absent, and when the CC is localized posteriorly. • Memory disorders are among typical cli...

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Published in:	World neurosurgery Vol. 105; pp. 678 - 688
Main Authors:	Konovalov, Alexander N., M.D, Pitskhelauri, David I., M.D, Shkarubo, Michael, Buklina, Svetlana B., M.D, Poddubskaya, Anna A, Kolycheva, Mariya
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-09-2017
Subjects:	Adolescent Adult Aged Child Child, Preschool Colloid cyst Colloid Cysts - diagnostic imaging Colloid Cysts - surgery Female Follow-Up Studies Humans Infant Male Microsurgery Microsurgery - methods Middle Aged Neurosurgery Retrospective Studies Supracerebellar infratentorial approach Third ventricle Third Ventricle - diagnostic imaging Third Ventricle - surgery Transcallosal approach Treatment Outcome Young Adult Colloid cyst CC CT EVD MRI CSF Microsurgery Supracerebellar infratentorial approach Third ventricle VPS Transcallosal approach
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Abstract	Highlights • The transcallosal approach allows for a radical third ventricle colloid cyst resection with a minimal complication rate. • The supracerebellar infratentorial approach helpful when hydrocephalus is absent, and when the CC is localized posteriorly. • Memory disorders are among typical clinical manifestations of colloid cysts of the third ventricle observed both before surgery and in the immediate postoperative period
AbstractList	This study analyzes the results of surgical treatment in 377 patients with colloid cysts (CCs) of the third ventricle who were treated at the Burdenko Neurosurgery Institute from 1981 to 2015. Operations were performed by a single surgeon (the first author of the article). The transcallosal approach was used to remove CCs in 97% of cases. Total cyst removal was performed in 96% of cases (in 4% of cases, a small cyst capsule fragment was left on the veins and fornix); in 3 cases, the cyst recurred, which required its repeated removal. Hydrocephalus symptoms regressed in 98% of patients. The most frequent complications in the early postoperative period were memory impairments of varying severity, with a tendency to regress by the time of discharge. Two patients had an intraventricular hematoma, which required operative exploration in 1 patient. There were 4 cases of meningitis (including 1 shunt-associated meningitis) and 5 cases of transient pyramidal insufficiency. We made a preliminary assessment of the reasonability of the infratentorial supracerebellar approach for removal of CCs in 10 cases. Highlights • The transcallosal approach allows for a radical third ventricle colloid cyst resection with a minimal complication rate. • The supracerebellar infratentorial approach helpful when hydrocephalus is absent, and when the CC is localized posteriorly. • Memory disorders are among typical clinical manifestations of colloid cysts of the third ventricle observed both before surgery and in the immediate postoperative period BACKGROUNDThis study analyzes the results of surgical treatment in 377 patients with colloid cysts (CCs) of the third ventricle who were treated at the Burdenko Neurosurgery Institute from 1981 to 2015. Operations were performed by a single surgeon (the first author of the article).METHODSThe transcallosal approach was used to remove CCs in 97% of cases. Total cyst removal was performed in 96% of cases (in 4% of cases, a small cyst capsule fragment was left on the veins and fornix); in 3 cases, the cyst recurred, which required its repeated removal.RESULTSHydrocephalus symptoms regressed in 98% of patients. The most frequent complications in the early postoperative period were memory impairments of varying severity, with a tendency to regress by the time of discharge. Two patients had an intraventricular hematoma, which required operative exploration in 1 patient. There were 4 cases of meningitis (including 1 shunt-associated meningitis) and 5 cases of transient pyramidal insufficiency.CONCLUSIONSWe made a preliminary assessment of the reasonability of the infratentorial supracerebellar approach for removal of CCs in 10 cases.
Author	Poddubskaya, Anna A Pitskhelauri, David I., M.D Buklina, Svetlana B., M.D Shkarubo, Michael Konovalov, Alexander N., M.D Kolycheva, Mariya
Author_xml	– sequence: 1 fullname: Konovalov, Alexander N., M.D – sequence: 2 fullname: Pitskhelauri, David I., M.D – sequence: 3 fullname: Shkarubo, Michael – sequence: 4 fullname: Buklina, Svetlana B., M.D – sequence: 5 fullname: Poddubskaya, Anna A – sequence: 6 fullname: Kolycheva, Mariya
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/28619498$$D View this record in MEDLINE/PubMed
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Keywords	Colloid cyst CC CT EVD MRI CSF Microsurgery Supracerebellar infratentorial approach Third ventricle VPS Transcallosal approach
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Snippet	Highlights • The transcallosal approach allows for a radical third ventricle colloid cyst resection with a minimal complication rate. • The supracerebellar... This study analyzes the results of surgical treatment in 377 patients with colloid cysts (CCs) of the third ventricle who were treated at the Burdenko... BACKGROUNDThis study analyzes the results of surgical treatment in 377 patients with colloid cysts (CCs) of the third ventricle who were treated at the...
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SubjectTerms	Adolescent Adult Aged Child Child, Preschool Colloid cyst Colloid Cysts - diagnostic imaging Colloid Cysts - surgery Female Follow-Up Studies Humans Infant Male Microsurgery Microsurgery - methods Middle Aged Neurosurgery Retrospective Studies Supracerebellar infratentorial approach Third ventricle Third Ventricle - diagnostic imaging Third Ventricle - surgery Transcallosal approach Treatment Outcome Young Adult
Title	Microsurgical Treatment of Colloid Cysts of the Third Ventricle
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