Abstract
Colloid cysts are benign space-occuping lesions, which arise from the velum interpositum or the choroid plexus of the third ventricle and are able to produce symptomatic obstruction of the foramina of Monro with resultant hydrocephalus. In our department, we have operated on colloid cysts routinely in an endoscope-assisted microsurgical manner via a key–hole approach. During a period of 10 years, 28 microsurgical resections of colloid cysts of the third ventricle were performed. Seven patients demonstrated colloid cysts inside the third ventricle with obstruction of the right foramen Monro, two patients demonstrated cysts with obstruction of the left foramen Monro. Twelve patients suffered from cysts inside the third ventricle with obstruction of both foramina Monro and five patients demonstrated cysts lying into the third ventricle without obstruction of the foramina. In 21 patients no preoperative therapy was performed outside. Three patients had received shunt systems before in other hospitals, two patients received aspiration of the cysts under stereotactic conditions and two patients received external ventricular drains. Total removal of the cyst was achieved in all patients (100%). No patient received a second operation, because none had a recurrent cyst. All cysts were removed with the cyst wall. Overall clinical improvement was achieved in a long-standing period between 6 and 83 months in 27 (96%) patients. In one patient (4%) the psychomotor disturbance was unchanged and no patient deteriorated. From the microsurgical point of view, the combination of keyhole surgery under endoscopic visual control using preexisting anatomical windows offers an effective minimally invasive approach.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10143-005-0419-0/MediaObjects/s10143-005-0419-0fhc1.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10143-005-0419-0/MediaObjects/s10143-005-0419-0fhc2.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10143-005-0419-0/MediaObjects/s10143-005-0419-0fhb3.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10143-005-0419-0/MediaObjects/s10143-005-0419-0fhc4.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10143-005-0419-0/MediaObjects/s10143-005-0419-0fhb5.jpg)
Similar content being viewed by others
References
Abdou MS, Cohen AR (2000) Endoscopic surgery of the third ventricle: the subfrontal trans–lamina terminalis approach. Minim Invasive Neurosurg 43:208–211
Abernathey CD, Davis DH, Kelly PJ (1989) Treatment of colloid cysts of the third ventricle by stereotaxic microsurgical laser craniotomy. J Neurosurg 70:525–529
Albin MS, Bunegin L, Bennett MH, Dujovny M, Jannetta PJ (1977) Clinical and experimental brain retraction pressure monitoring. Acta Neurol Scand Suppl 64:522–523
Albin MS, Bunegin L, Dujovny M, Bennett MH, Jannetta PJ, Wisotzkey HM (1975) Brain retraction pressure during intracranial procedures. Surg Forum 26:499–500
Andrews RJ, Bringas JR (1993) A review of brain retraction and recommendations for minimizing intraoperative brain injury. Neurosurgery 33:1052–1063; discussion 1063–1064
Antunes JL, Louis KM, Ganti SR (1980) Colloid cysts of the third ventricle. Neurosurgery 7:450–455
Bertalanffy H, Kretzschmar H, Gilsbach JM, Ott D, Mohadjer M (1990) Large colloid cyst in lateral ventricle simulating brain tumour. Case report. Acta Neurochir (Wien) 104:151–155
Bosch DA, Rahn T, Backlund EO (1978) Treatment of colloid cysts of the third ventricle by stereotactic aspiration. Surg Neurol 9:15–18
Caemaert J, Abdullah J, Calliauw L (1994) Endoscopic diagnosis and treatment of para– and intra–ventricular cystic lesions. Acta Neurochir Suppl (Wien) 61:69–75
Camacho A, Abernathey CD, Kelly PJ, Laws ER Jr (1989) Colloid cysts: experience with the management of 84 cases since the introduction of computed tomography. Neurosurgery 24:693–700
Cohen AR (1994) Ventriculoscopic surgery. Clin Neurosurg 41:546–562
Deinsberger W, Boker DK, Samii M (1994) Flexible endoscopes in treatment of colloid cysts of the third ventricle. Minim Invasive Neurosurg 37:12–16
Donauer E, Moringlane JR, Ostertag CB (1986) Colloid cysts of the third ventricle. Open operative approach or stereotactic aspiration? Acta Neurochir (Wien) 83:24–30
Fries G, Perneczky A, van Lindert E, Bahadori–Mortasawi F (1997) Contralateral and ipsilateral microsurgical approaches to carotid–ophthalmic aneurysms. Neurosurgery 41:333–342; discussion 342–333
Hall WA, Lunsford LD (1987) Changing concepts in the treatment of colloid cysts. An 11–year experience in the CT era. J Neurosurg 66:186–191
Hasegawa T, Yamano K, Miyamori T, Hamada Y (1991) A micromanipulator for precise control of a brain retractor. Technical note. J Neurosurg 74:1009–1010
Hellwig D, Bauer BL (1992) Minimally invasive neurosurgery by means of ultrathin endoscopes. Acta Neurochir Suppl (Wien) 54:63–68
Hellwig D, Bauer BL, Schulte M, Gatscher S, Riegel T, Bertalanffy H (2003) Neuroendoscopic treatment for colloid cysts of the third ventricle: the experience of a decade. Neurosurgery 52:525–533; discussion 532–523
Jeeves MA, Simpson DA, Geffen G (1979) Functional consequences of the transcallosal removal of intraventricular tumours. J Neurol Neurosurg Psychiatry 42:134–142
Kondziolka D, Lunsford LD (1991) Stereotactic management of colloid cysts: factors predicting success. J Neurosurg 75:45–51
Lewis AI, Crone KR, Taha J, van Loveren HR, Yeh HS, Tew JM Jr (1994) Surgical resection of third ventricle colloid cysts. Preliminary results comparing transcallosal microsurgery with endoscopy. J Neurosurg 81:174–178
Little JR, MacCarty CS (1974) Colloid cysts of the third ventricle. J Neurosurg 40:230–235
Mathiesen T, Grane P, Lindgren L, Lindquist C (1997) Third ventricle colloid cysts: a consecutive 12–year series. J Neurosurg 86:5–12
Mathiesen T, Grane P, Lindquist C, von Holst H (1993) High recurrence rate following aspiration of colloid cysts in the third ventricle. J Neurosurg 78:748–752
Mohadjer M, Teshmar E, Mundinger F (1987) CT–stereotaxic drainage of colloid cysts in the foramen of Monro and the third ventricle. J Neurosurg 67:220–223
Musolino A, Fosse S, Munari C, Daumas–Duport C, Chodkiewicz JP (1989) Diagnosis and treatment of colloid cysts of the third ventricle by stereotactic drainage. Report on eleven cases. Surg Neurol 32:294–299
Pallini R, Bozzini V, Scerrati M, Zuppi C, Zappacosta B, Rossi GF (1991) Bone metastasis associated with shunt–related peritoneal deposits from a pineal germinoma. Case report and review of the literature. Acta Neurochir (Wien) 109:78–83
Parkinson D, Childe AE (1952) Colloid cyst of the fourth ventricle; report of a case of two colloid cysts of the fourth ventricle. J Neurosurg 9:404-409
Perneczky A, Fries G (1998) Endoscope–assisted brain surgery: part 1—evolution, basic concept, and current technique. Neurosurgery 42:219–224; discussion 215–224
Powell MP, Torrens MJ, Thomson JL, Horgan JG (1983) Isodense colloid cysts of the third ventricle: a diagnostic and therapeutic problem resolved by ventriculoscopy. Neurosurgery 13:234–237
Rivas JJ, Lobato RD (1985) CT–assisted stereotaxic aspiration of colloid cysts of the third ventricle. J Neurosurg 62:238–242
Schroder R, Sanker P, Thun F, Richard KE (1990) Cysts of the third ventricle. Zentralbl Neurochir 51:42–48
Shucart WA, Stein BM (1978) Transcallosal approach to the anterior ventricular system. Neurosurgery 3:339–343
Symon L, Pell M, Yasargil MG, Sarioglu AC, Adamson TE, Roth P, Ostertag CB, Caemart J, Calliauw L (1990) Surgical techniques in the management of colloid cysts of the third ventricle. Adv Tech Stand Neurosurg 17:121–157
Wilkins RH, Dott NM, Dandy WF (1964) Neurosurgical Classics–Xxiv. J Neurosurg 21:892–905
Yokoh A, Sugita K, Kobayashi S (1987) Clinical study of brain retraction in different approaches and diseases. Acta Neurochir (Wien) 87:134–139
Acknowledgements
We received no financial support to analyze the reported data and we have no financial interest in any materials or devices described in our submission. Furthermore, we want to thank our neuroradiological assistant, Ms. Janice Roberts, for preparing the revision of the manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Charalampaki, P., Filippi, R., Welschehold, S. et al. Endoscope-assisted removal of colloid cysts of the third ventricle. Neurosurg Rev 29, 72–79 (2006). https://doi.org/10.1007/s10143-005-0419-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10143-005-0419-0