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Colloid cyst

Colloid cyst is a benign cystic lesion at the Foramen of Monroe. It causes obstruction at the Foramen of Monroe resulting in hydrocephalus and raised intracranial pressure symptoms as headache, vomitting, blurring of vision. The images in the first column are of a 25 year old patient who presented with these features of raised ICP. MRI revealed a colloid cyst in the third ventricle causing obstruction of Foramen of Monroe with resultant hydrocephalus.
Conventionally, a craniotomy and a transcallosal microscopic approach is used for excising these tumors. With advances in Endoscopy, these can now be removed with Endoscopes. Endoscopic excision of these lesions using transcranial approach results in good functional and cognitive outcomes. A Single burr hole of 14mm diameter is adequate to remove this tumor.
Navigation assistance is very helpful in planning the appropriate trajectory.
The images on the right are intra-operative images of this patient. The colloid cyst was excised successfully.
Aids used: Endoscope, Neuro-navigation

Fig 1. Pre-op MRI showing colloid cyst with hydrocephalus

Fig 2. Post-op CT scan with excised colloid cyst and patent Foramen of Monroe

Fig 3. Patient following Endoscopic Transcranial excision of the colloid cyst

Endoscope in Lateral ventricle with colloid cyst blocking the Foramen of Monroe

Colloid material

Patent Foramen of Monroe following excision of Colloid cyst
Intra-operative images of Colloid cyst following Endoscopic Transcranial excision of the lesion