Clinical symptoms and surgical outcome of colloid cysts of the third ventricle: A multicenter retrospective study
Vicki-Marie Butenschön (München), Alexander Quiring (München), Nicole Lange (München), Lidia Mikhina (Hamburg), Jens Gempt (Hamburg), Mukesch Shah (Freiburg i. Br.), Jürgen Beck (Freiburg i. Br.), Petros Evangelou (Göttingen), Veit Rhode (Göttingen), Dragan Jankovic (Mainz), Florian Ringel (Mainz), Insa Janssen (Genf / CH), Karl Schaller (Genf / CH), Christian Freyschlag (Innsbruck / AT), Claudius Thomé (Innsbruck / AT), Stefanie Maurer (Frankfurt a. M.), Marcus Czabanka (Frankfurt a. M.), Patrick Leissa (Berlin), Peter Vajkoczy (Berlin), Bernhard Meyer (München)
Colloid cysts of the third ventricle are rare benign brain lesions that can lead to potentially life-threatening hydrocephalus. Surgical removal is the primary treatment option, involving minimally invasive endoscopic or microsurgical techniques.
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.
We collected data on 192 patients operated upon between 2006 and 2022. The mean age was 46 years; 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.
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.