Complete endoscopic removal of colloid cyst using a nitinol basket retriever

2011 ◽  
Vol 30 (4) ◽  
pp. E8 ◽  
Author(s):  
Clemens M. Schirmer ◽  
Carl B. Heilman
Keyword(s):  
Urinary Incontinence ◽  
Lateral Ventricle ◽  
Memory Loss ◽  
Colloid Cyst ◽  
Ventricular System ◽  
Ventricular Wall ◽  
Endoscopic Removal ◽  
Flexible Wall ◽  
Colloid Cysts ◽  
Occipital Horn

Neuroendoscopic treatment of colloid cysts is limited by the reach and flexibility of the instruments that can be passed through the working channels of the rigid neuroendoscope. The authors describe a case of a third ventricular colloid cyst where a large solid colloid fragment was recovered using a nitinol stone retrieval basket as a flexible wall-guided atraumatic salvage instrument. A flexible nitinol stone retrieval basket was successfully used through an endoscopic working channel to retrieve a large portion of the colloid cyst from the occipital horn of the lateral ventricle in a 70-year-old man who presented with progressive memory loss, urinary incontinence, and slowness of gait. A flexible nitinol stone retrieval basket can be safely and effectively maneuvered in the ventricular system, using the ventricular wall for deflection, and can be used to retrieve colloid cyst fragments as a salvage technique. Remaining free-floating large colloid cyst fragments in the ventricular system do not necessarily require a second craniotomy or bur hole for access but may be retrieved using a nitinol stone retrieval basket.

Endoscopic Colloid Cyst Resection in the Absence of Ventriculomegaly

2013 ◽  
Vol 73 (suppl_1) ◽  
pp. ons39-ons47 ◽  
Author(s):  
Scott D. Wait ◽  
Roberto Gazzeri ◽  
David A. Wilson ◽  
Adib A. Abla ◽  
Peter Nakaji ◽  
...  
Keyword(s):  
Short Term Memory ◽  
Memory Loss ◽  
High Volume ◽  
Colloid Cyst ◽  
Complication Rates ◽  
Endoscopic Removal ◽  
Short Term ◽  
Term Memory ◽  
Colloid Cysts ◽  
Microsurgical Resection

Abstract BACKGROUND: The absence of ventriculomegaly has been considered an overt or relative contraindication to the endoscopic resection of colloid cysts. In the past, endoscopic removal of colloid cysts in the absence of ventriculomegaly has been considered ill advised. Reports of successful endoscopic surgery in small ventricles are surfacing. OBJECTIVE: We examined the combined experience of 2 high-volume endoscopic centers to characterize the outcomes of patients undergoing endoscopic removal of colloid cysts in small ventricles. METHODS: We retrospectively reviewed all endoscopic colloid cyst removal procedures by the 2 senior authors (P.N., C.T.) performed at the Barrow Neurological Institute over an 8-year period. Radiographic, clinical, and interview data were recorded and analyzed. The age-adjusted relative bicaudate index was used to define small ventricles. RESULTS: Sixteen patients (8 female) underwent attempted endoscopic removal of a colloid cyst in the absence of ventriculomegaly. Surgery was technically successful in 15 patients. The cyst was removed completely in 13 of patients. Short-term memory loss was initially present in 3 patients and completely resolved in all but 1 patient who had presented with short-term memory loss. Temporary complications occurred in 2 patients. CONCLUSION: Normal-size ventricles are not a contraindication to endoscopic removal of third ventricular colloid cysts. Complication rates are at least comparable to those of patients with ventriculomegaly or to those undergoing open microsurgical resection.

Sudden Death of a 22-Year-Old Female Attributed to Complications of a Colloid Cyst in the Third Ventricle

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S76-S76
Author(s):  
Gary Wu ◽  
Jennifer Hammers
Keyword(s):  
Sudden Death ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Memory Loss ◽  
Colloid Cyst ◽  
Intracranial Tumors ◽  
Foramen Of Monro ◽  
Acute Hydrocephalus ◽  
The Third ◽  
Colloid Cysts

Abstract Colloid cysts are rare lesions that account for up to 2% of all intracranial tumors. They are commonly found posterior to the foramen of Monro in the third ventricle and classified as benign lesions due to their slow-growing nature. Diagnosis of colloid cysts are often incidental finds on diagnostic imaging or at autopsy. The strategic location of these cysts primary causes gradual or acute hydrocephalus, as evidenced by flattened gyri and deepened sulci on MRI, nausea, vomiting, and papilledema. Enlargement of the cyst itself can cause a mass effect, which commonly presents with symptoms of ataxia, memory loss, and rapid neurologic deterioration. Microsurgery, endoscopic removal, and stereotactic aspiration are cited to be the most commonly employed treatments in the management of colloid cysts. However, there is no one procedure better than another; the benefits and limitations of several procedures are discussed. Treatment of choice is weighed by clinical judgment and surgical experience that vary between neurosurgeons. Although benign, colloid cysts rarely but can lead to sudden death. Therefore, it is important to consider colloid cysts and other intracranial tumors on the differential diagnosis when presented with acute hydrocephalus and papilledema. We report a case of sudden death in a 22-year-old black female due to obstructive hydrocephalus by a colloid cyst in the third ventricle.

scholarly journals Extruded contents of colloid cysts after endoscopic removal

2016 ◽  
Vol 125 (3) ◽  
pp. 570-575 ◽  
Author(s):  
Assem M. Abdel Latif ◽  
Mark M. Souweidane
Keyword(s):  
Colloid Cyst ◽  
Solid Matrix ◽  
Endoscopic Removal ◽  
Imaging Studies ◽  
Clinical Notes ◽  
Migratory Capacity ◽  
Colloid Cysts ◽  
Imaging Surveillance ◽  
Operative Notes

OBJECTIVE Mineralized or desiccated colloid cysts pose some unique challenges to endoscopic removal. The extrusion of the solid matrix into the intraventricular compartment has not been previously reported and, as such, no guidance exists regarding its predilection, prevention, and fate. METHODS Postoperative imaging studies in a registry of patients undergoing endoscopic removal of colloid cyst were reviewed to detect any solid matrix within the ventricular compartment. Preoperative images and operative notes were used to determine if any features were predictive. Serial postoperative images and clinical notes were used to characterize the implications of these findings. RESULTS From a review of 94 patients, 10 (10.6%) patients had evidence of an extruded intraventricular solid fragment (median follow-up 4 months; range 0.5–115 months). Of the evaluable patients, 7 of 9 patients had T1-weighted hyperintense and T2-weighted hypointense cysts on preoperative scans. Seventy-eight percent of the extrusions were on the same side as the endoscopic entry. Three patients demonstrated early fragment migration, but not after 8 months of radiological follow-up. All evaluable patients demonstrated improvement in their hydrocephalus, and none suffered a complication attributable to the intraventricular extruded fragments. CONCLUSIONS Intraventricular extruded colloid fragments can occur after endoscopic resection, with the possible risk demonstrated as cyst hypointensity on preoperative T2-weighted images. The finding does not seem to result in any clinical morbidity, and radiographic involution is the rule. Migratory capacity, however, does exist and justifies a more frequent imaging surveillance schedule and consideration for removal.

scholarly journals Endoscopic resection of colloid cyst: long-term followup with 65 patients

2015 ◽  
Vol 42 (S1) ◽  
pp. S20-S20
Author(s):  
MG Hamilton ◽  
A Isaacs ◽  
G Urbaneja ◽  
W Hader ◽  
H Yong
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Treatment ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Surgical Approaches ◽  
Consecutive Series ◽  
Endoscopic Removal ◽  
The Third ◽  
Colloid Cysts

Introduction: Colloid cysts of the third ventricle are rare, histologically benign lesions that can be associated with obstructive hydrocephalus. Endoscopic removal developed as an alternative to microsurgical craniotomy as a less invasive surgical treatment. This review examines the endoscopic surgical experience for a consecutive series of patients with colloid cyst of the third ventricle. Methods: Patients with a diagnosis of “colloid cyst of the third ventricle” who were treated in Calgary between January 1994 and July 2014 were reviewed using a clinic database and registry. Results: 95 patients were identified. 30 patients without hydrocephalus underwent serial MRI and clinical observation with one patient developing hydrocephalus leading to surgical treatment. 65 patients underwent endoscopic treatment of their colloid cyst (male=34; female=31). The mean age at diagnosis was 45.5 years. 3 patients had been previously treated with other surgical approaches. All surgically treated patients had hydrocephalus and hydrocephalus resolved in all 65 patients. 1 patient sustained an injury to the internal capsule with transient hemiparesis. Mean followup was 8.2 years (range 0.1-19.3 years). 3 patients experienced colloid cyst recurrence treated with a second endoscopic removal. Conclusion: Endoscopic treatment of third ventricle colloid cysts can be performed with low risk as an alternative to microsurgical resection.

scholarly journals Endoscopic removal of recurrent colloid cysts

2020 ◽  
Vol 132 (5) ◽  
pp. 1636-1641
Author(s):  
Jacques J. Lara-Reyna ◽  
Rafael Uribe-Cardenas ◽  
Imali Perera ◽  
Nicholas Szerlip ◽  
Anastasios Giamouriadis ◽  
...  
Keyword(s):  
Third Ventricle ◽  
Complete Removal ◽  
Colloid Cyst ◽  
Categorical Variables ◽  
Endoscopic Removal ◽  
The Third ◽  
Significant Difference ◽  
Colloid Cysts ◽  
Recurrent Cyst ◽  
Primary Cyst

OBJECTIVERemoval of colloid cysts of the third ventricle using a purely endoscopic method has been established as a safe and advantageous technique. It is hypothesized that endoscopic removal in recurrent cases might pose more technical challenges and result in less success. The objective of this study was to assess the feasibility and outcomes of using a purely endoscopic approach for the management of recurrent colloid cysts compared to primary cysts.METHODSA retrospective cohort study was performed on patients who underwent purely endoscopic removal of their colloid cyst. Descriptive statistics were compared for patients undergoing surgery for a recurrent cyst and those for a control cohort undergoing surgery for a primary cyst. Bivariate analysis was conducted using a Fisher’s exact test for categorical variables and Mann-Whitney U-test for continuous variables.RESULTSIn total, 121 patients had a primary colloid cyst endoscopically removed and 10 patients had a total of 11 recurrent cysts removed. Recurrence or progression after surgery occurred in 3 (2.5%) cases in the primary cyst group and 2 (18.2%) cases in the recurrent cyst group. Symptomatic presentation during the follow-up period occurred in 6 (54.5%) cases in the recurrent cyst group versus 75 (62%) cases in the primary cyst group (p = 0.749). Two patients (20%) in the recurrent group had a second recurrence in a mean period of 30 months (1 patient at 15 and 1 patient at 45 months). One of these patients required a tertiary endoscopic removal 8 years after the second resection. No immediate postoperative complications or new morbidities were observed after repeat endoscopic surgery. The authors’ findings indicated a nonsignificant trend toward a higher recurrence rate (18.2% vs 2.5%, p = 0.055) and a decreased proportion of complete removal (90.9% vs 81.8%, p = 0.296) in the recurrent cyst group compared to the primary cyst group. However, a significantly higher rate of preoperative hydrocephalus was observed in the primary cyst group compared with the recurrent cyst group (63.6% vs 18.2%, p = 0.007).CONCLUSIONSPurely endoscopic approaches for the removal of recurrent colloid cysts of the third ventricle are feasible and equally safe compared with endoscopic removal of primary cysts. The study’s findings did not show a statistically significant difference in the rate of recurrence between the 2 groups. The proportion of patients with symptomatic cysts on presentation was lower in patients with recurrent cysts than in patients with primary cysts. Due to the high rate of complete removal with negligible morbidity, the authors continue to advocate for an endoscopic removal at the time of cyst recurrence.

scholarly journals Neuroendoscopic fenestration of glioependymal cysts to the ventricle: report of 3 cases

2019 ◽  
Vol 131 (5) ◽  
pp. 1615-1619
Author(s):  
Anthony M. Alvarado ◽  
Kyle A. Smith ◽  
Roukoz B. Chamoun
Keyword(s):  
Minimally Invasive ◽  
Lateral Ventricle ◽  
Mass Effect ◽  
Ventricular System ◽  
Open Resection ◽  
Presenting Symptoms ◽  
Glioependymal Cyst ◽  
The Central Nervous System ◽  
Surgical Treatments ◽  
Endoscopic Fenestration

Glioependymal cysts are rare congenital lesions of the central nervous system. Reported surgical treatments of these lesions have varied and yielded mixed results, and the optimal surgical strategy is still controversial. The authors here report the clinical and surgical outcomes for three adult patients successfully treated with neuroendoscopic fenestration into the ventricular system. The patients had presented with symptomatic glioependymal cysts in the period from 2013 to 2016 at the authors’ institution. All underwent minimally invasive neuroendoscopic fenestration of the glioependymal cyst into the lateral ventricle via a stereotactically guided burr hole. Presenting clinical and radiological findings, operative courses, and postintervention outcomes were evaluated.All three patients initially presented with symptoms related to regional mass effect of the underlying glioependymal cyst, including headaches, visual disturbances, and hemiparesis. All patients were successfully treated with endoscopic fenestration of the cyst wall into the lateral ventricle, where the wall was thinnest. Postoperatively, all patients reported improvement in their presenting symptoms, and neuroimaging demonstrated decompression of the cyst. Clinical follow-up ranged from 4 months to 5 years without evidence of reexpansion of the cyst or shunt requirement.Compared to open resection and shunting of the cyst contents, minimally invasive endoscopic fenestration of a glioependymal cyst into the ventricular system is a safe and effective surgical option. This approach is practical, is less invasive than open resection, and appears to provide a long-term solution.

Neurosurgical management of a giant colloid cyst with atypical clinical and radiological presentation

2014 ◽  
Vol 121 (5) ◽  
pp. 1185-1188 ◽  
Author(s):  
Joel Woodley-Cook ◽  
Jaime L. Martinez ◽  
Anish Kapadia ◽  
David G. Munoz ◽  
Aditya Bharatha ◽  
...  
Keyword(s):  
Vision Loss ◽  
Obstructive Hydrocephalus ◽  
Memory Loss ◽  
Final Diagnosis ◽  
Colloid Cyst ◽  
Ct Scans ◽  
Mr Images ◽  
Diagnostic Dilemma ◽  
Foramen Of Monro ◽  
Histopathological Investigation

The finding of a colloid cyst on neuroimaging is often incidental. These lesions are usually located at the foramen of Monro, are hyperdense on CT scans, and generally demonstrate signal intensity of water on MR images, although this depends on their content. When symptomatic, they frequently present with headaches and nausea due to an obstructive hydrocephalus. The authors describe a case of a giant colloid cyst in a patient presenting with complete left-sided vision loss and progressive memory loss, two very atypical findings in colloid cyst presentation. Imaging findings were also atypical, and this case proved to be a diagnostic dilemma because of its clinical and radiological presentation. Histopathological investigation was of utmost importance in the final diagnosis of a colloid cyst. To the authors' knowledge this colloid cyst is larger than any other described in the literature.

COLLOID CYSTS OF THE THIRD VENTRICLE: A REVIEW OF SIXTEEN CASES

2021 ◽  
pp. 62-64
Author(s):  
Y Srinivas Rao ◽  
Hemal Chheda ◽  
Ch Surendra ◽  
M V Vijayasekhar ◽  
K Satya Varaprasad
Keyword(s):  
Benign Lesion ◽  
Third Ventricle ◽  
Clinical Manifestations ◽  
Colloid Cyst ◽  
Surgical Approaches ◽  
Imaging Features ◽  
Complete Excision ◽  
Advantages And Disadvantages ◽  
The Third ◽  
Colloid Cysts

BACKGROUND : Colloid cysts are one of the rare brain tumours and are mostly located in the anterosuperior portion of the third ventricle, between the fornix and surround of Foramen of Monroe. OBJECTIVES: Ÿ 1.To review the demographic information & analyse clinical manifestations of patients presenting with colloid cyst of third ventricle. Ÿ 2.To analyze the advantages and disadvantages of various surgical approaches Ÿ 3.To assess the surgical outcome in colloid cyst patients operated by any method. MATERIALS AND METHODS: A retrospective study was performed on 16 patients who presented with a colloid cyst and underwent surgery at the Department of Neurosurgery, King George Hospital, Andhra Medical College between 2013-2018. They were evaluated based on clinical ndings and imaging features, surgical approaches used for resection and their outcomes. RESULTS: Sixteen cases of colloid cyst of the third ventricle were operated upon between 2013-2018. There were seven male and nine female patients with their ages varying between 9 and 62 years old. Nine patients were operated on by using a transcortical trans-ventricular approach, four using the anterior trans-callosal approach and, three patients by using an endoscopic approach. In all patients, complete excision of the lesions was achieved. CONCLUSION: Colloid cysts, though benign, present surgical challenges because of its deep midline location. Complete excision of the colloid cyst carries an excellent prognosis. Surgery is a safe and effective treatment option for this benign lesion.

scholarly journals COLLOID CYST OF THE THIRD VENTRICLE

2010 ◽  
Vol 17 (01) ◽  
pp. 156-163
Author(s):  
NAVEED ASHRAF ◽  
MUHAMMAD AKMAL AZEEMI ◽  
FAUZIA SAJJAD ◽  
Asma Ghouri
Keyword(s):  
Clinical Success ◽  
Standard Procedure ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Invasive Approach ◽  
Keyhole Surgery ◽  
The Third ◽  
Number Of Patients ◽  
Colloid Cysts ◽  
Microsurgical Resection

Objectives: Cerebrospinal fluid shunting or microsurgical resection of the colloid cysts of the third ventricle have long been a standard treatment. The emergence of neuroendoscopy has lead to its application in various neurosurgical problems. Colloid cyst of the third ventricle is one such pathology where endoscopic treatment has been performed with great clinical success during the past decade. We now Although considered less efficacious than microsurgical excision endoscopic excision is less invasive and much simpler.Objectives: (1) to assess the extent of excision (2) to assess the morbid anatomy of the colloid cyst (3) to assess the risk of complications (4) to assess the functional outcome. Period: Eight years (Jul 2001-June 2009) Materials and Methods: Endoscopic resections of 15 colloid cysts of the third ventricle with obstruction of Foramina of Monroe in all cases. Results: Total removal was achieved in 10 (66.7%) cases. In 5 (33.3%) patients the colloid material was evacuated completely while the remnant of the capsule adherent to its origin was left behind. Two (13.3%) patients developed meningitis one week postoperatively and one diedsubsequently. Nine (60%) patients had excellent recovery as the symptoms were relieved during a period of 3 to 24 months. Five (33.3%) of the total patients required ventriculoperitoneal shunt for obstructivey drocephalus which developed with in 2 weeks after surgery. One out of the total number of patients deteriorated postoperatively on the existing neurological deficit. There has not been any recurrence until now with subtotal excision of the capsule. Conclusions: Keyhole surgery under endoscopic visual control offers an alternative, very effective minimally invasive approach for the excision of colloid cyst of the third ventricle and is likely to replace microsurgical resection as a standard procedure.

scholarly journals Third ventricular colloid cyst causing acute hydrocephalus during early pregnancy: Clinical lessons from a case

2021 ◽  
Vol 12 ◽  
pp. 54
Author(s):  
Ching Chung Foo ◽  
Pasquale Gallo ◽  
Chandrasekaran Kaliaperumal
Keyword(s):  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
False Negative ◽  
Colloid Cyst ◽  
Radiological Investigation ◽  
Foramen Of Monro ◽  
Acute Hydrocephalus ◽  
Healthy Neonate ◽  
Trimester Pregnancy ◽  
Colloid Cysts

Background: Colloid cysts of third ventricle are rare lesions which may present with symptoms of acute hydrocephalus. We report a case of acute obstructive hydrocephalus secondary to third ventricular colloid cyst and its management during 1st trimester pregnancy. Case Description: A 31-years-old lady presented to the emergency department with reduced consciousness. Computed tomography head showed obstructive hydrocephalus and an obstructing lesion near foramen of Monro suggestive of third ventricle colloid cyst. She underwent endoscopic resection of colloid cyst. Her pregnancy was only confirmed after surgery and she delivered a healthy neonate at full term. She has remained clinically well and had resumed her work as a general practitioner. Conclusion: This case illustrates that urinary pregnancy test may show false negative result but pregnancy should not preclude radiological investigation and neurosurgical intervention in patients with deteriorating neurological function.

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