Colloid Cysts

05 November 2004

Prevalence: 3.2/1,000,000

Almost exclusively in anterior portion of third ventricle

CLINICAL

1.Ball valve obstruction of third ventricle

paroxysmal headaches associated with changes in posture due to obstruction of foramen of Munro or aqueduct of Sylvius

2.”Drop attacks”

            Sudden weakness in lower limbs causing falls without LOC

3.Raised intracranial pressure associated progressive headache

            Common presentation

4.Hakim’s triad (gait disturbance, incontinence, dementia)

            Differentiate from NPH esp with regards to doing LP

5.Sudden death

            acute hydrocephalus, effect on hypothalamic cardiovascular respiratory center, ?

6.Asymtomatic incidentaloma

INDICATIONS FOR SURGERY

1.Symptomatic

2.Hydrocephalus on imaging with normal patient

3.Increased cyst size

No known predictors of adverse prognosis in asymptomatic cysts (inc size, degree of ventricular dilatation)

SURGERY