Clinical symptoms and surgical outcome of colloid cysts of the third ventricle: a multicenter retrospective study

Sunday, May 5, 2024

2:21 PM – 2:23 PM CT

Location: S405a

Presenting Author(s)

Vicki M. Butenschoen, MD, MSc (she/her/hers)

Consultant Neurosurgeon
Technical University Munich, School of Medicine
Munchen, DE

Co-Author(s)

JB

Jurgen Beck, n/a

Chief of Department
University Clinic Freiburg
Freiburg, Germany
MC

Markus Czabanka, n/a

Chief of Department
University Clinic Frankfurt, Germany
PE

Petros Evangelou, n/a

Resident
University Clinic Göttingen, Germany
Christian F. Freyschlag, n/a

Consultant Neurosurgeon
University Clinic Innsbruck
Innsbruck, Austria
JG

Jens Gempt, n/a

Chief of Department
University Clinic Hamburg, Germany
DJ

Dragan Jankovic, n/a

Resident
University Clinic Mainz, Germany
IJ

Insa Janssen, n/a

Consultant Neurosurgeon
University Clinic Geneva, Switzerland
NL

Nicole Lange, n/a

Attending Physician
Department of Neurosurgery, Technical University Munich, United States
PL

Patrick Leißa, n/a

Resident
University Clinic Berlin, Germany
SM

Stephanie Maurer, n/a

Resident
University Clinic Frankfurt, Germany
Bernhard Meyer, n/a

Chairman/Professor of Neurosurgery
Department of Neurosurgery, Technical Universtiy Munich
Munich, Germany
LM

Lidia Mikhina, n/a

Resident
University Clinic Hamburg, Germany
AQ

Alexander Quiring, n/a

Resident
Technical University Munich, School of Medicine, Germany
FR

Florian Ringel

Chief of Department
University Clinic Mainz
Mainz, Rheinland-Pfalz, Germany
VR

Veit Rohde, n/a

Chief of Department
University Clinic Göttingen, Germany
KS

Karl Schaller, n/a

Chief of Department
University Clinic Geneva, Switzerland
MS

Mukesch Shah, n/a

Consultant Neurosurgeon
University Clinic Freiburg, Germany
Claudius Thomé, n/a

Chief of Department
University Clinic Innsbruck
Innsbruck, Tirol, Austria
Peter Vajkoczy, n/a

Chief of Department
University Clinic Berlin
Berlin, Germany

Disclosure(s):

Vicki M. Butenschoen: No financial relationships to disclose

Introduction: Colloid cysts of the third ventricle are rare benign brain lesions that typically obstruct cerebrospinal fluid flow within the ventricular system. These cysts can lead to potentially life-threatening hydrocephalus. Surgical removal is the primary treatment option, involving minimally invasive endoscopic or microsurgical techniques. Our abstract highlights the significance of timely surgical intervention in alleviating hydrocephalus, preventing neurological complications, and investigating long-term clinical outcomes in a large patient cohort.

Methods: We performed a multicenter retrospective cohort study including all patients suffering from colloid cysts of the third ventricle operated upon in eight tertiary care neurosurgical departments from Germany, Austria, and Switzerland. Data assessment included preoperative symptoms focusing on the presence of chronic or acute hydrocephalus, pre-and postoperative imaging for the colloid cyst risk score, surgical technique, and long-term clinical outcome and shunt-dependency.

Results: We collected data on 194 patients operated upon between 2006 and 2022. The mean age was 46; 56% of the patients were male. Symptoms were present in 91.2% of the patients, including headache, vertigo, and memory loss. Acute hydrocephalus was diagnosed in 27.5% and chronic hydrocephalus in 38.7% of the patients. The mean cyst diameter was 12.7 mm, and most patients had a colloid cyst risk score of four out of five points. A microsurgical transcortical approach was chosen in 94% of the cases, and 23.4% opted for an intraoperative rescue EVD. Shunt dependency was observed in only 5% of the cases, all linked to postoperative ventriculitis. Long-term follow-up revealed a satisfying clinical status after a median of 10 months.

Conclusion : In our large cohort, most patients benefited from microsurgical approaches. The low rate of postoperative shunt dependency, primarily associated with ventriculitis, underscores the effectiveness of surgical management. Our findings support the favorable long-term clinical outcome, emphasizing the role of surgical treatment in alleviating symptoms and preventing complications in this rare condition.