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Erschienen in: The Journal of Headache and Pain 1/2015

Open Access 01.12.2015 | Poster presentation

P063. Colloid cysts of the third ventricle: a case report

verfasst von: Silvia de Pasqua, Valentina Favoni, Giulia Giannini, Rossana Terlizzi, Giulia Pierangeli, Pietro Cortelli, Sabina Cevoli

Erschienen in: The Journal of Headache and Pain | Sonderheft 1/2015

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Background

Colloid cysts are rare congenital benign tumors accounting for 0.2-2% of all intracranial neoplasms. They usually occur in the front part of the third ventricle. The clinical presentation is related to the increased intracranial pressure and is widely variable; sudden death associated with acute hydrocephalus can occur, therefore recognition of this rare condition is important in order to select an appropriate surgical treatment. We report a case of new onset headache secondary to a colloid cyst of the third ventricle.

Case report

A 44-year-old woman with unremarkable medical history was admitted to our clinic for recurrent attacks of pressing headache, with abrupt onset and brief duration, accompanied by nausea, transient hearing loss and tinnitus. These symptoms were relieved by supine position. The clinical picture progressively worsened, with episodes of vomiting during headache. Neurological examination was negative. A magnetic resonance imaging (MRI) scan showed a spherical mass lesion with lipid signal at the intraventricular foramina of Monro causing compression of the third ventricle and expansion of the ventricular system, suggestive of hydrocephalus.
After neurosurgical evaluation the patient underwent an endoscopic removal of the lesion. Histological findings were compatible with colloid cyst of the third ventricle. After surgical treatment the patient recovered completely from symptoms and the follow-up MRI demonstrated the complete excision of the lesion.

Conclusions

Colloid cysts are congenital, slow growing, benign intraventricular lesions usually arising in the third ventricle. They may cause obstruction of the foramen of Monro with blockage of cerebrospinal fluid (CSF) flow, producing progressive or intermittent elevated intracranial pressure with chronic or acute hydrocephalus [1]. The onset of symptoms is usually between 20 to 50 years of age, often with paroxismal attacks of severe headache associated with nausea and vomiting [2]. Presentations with thunderclap headache have also been described [3]. Headache can resolve or reduce in supine position, suggesting that the colloid cyst moves in and out of the foramen of Monro with intermittent obstruction of CSF. Colloid cysts, if left untreated, may lead to serious complications such as visual loss, memory difficulties, acute disturbances of consciousness and even sudden death as a consequence of acute obstructive hydrocephalus with brain herniation or cardiovascular failure due to abrupt disturbance of hypothalamic function. The risk of sudden neurologic deterioration cannot be predicted, therefore surgical treatment is recommended [1, 2].
Our case highlights the importance of early detection and prompt treatment of this potentially life-threatening cause of headache.
Written informed consent to publish was obtained from the patient(s).
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://​creativecommons.​org/​licenses/​by/​4.​0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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Literatur
1.
Zurück zum Zitat Ravnik J, Bunc G, Grcar A, Zunic M, Velnar T: Colloid cysts of the third ventricle exhibit various clinical presentation: a review of three cases. Bosn J Basic Med Sci. 2014, 14 (3): 132-135.PubMedCentralCrossRefPubMed Ravnik J, Bunc G, Grcar A, Zunic M, Velnar T: Colloid cysts of the third ventricle exhibit various clinical presentation: a review of three cases. Bosn J Basic Med Sci. 2014, 14 (3): 132-135.PubMedCentralCrossRefPubMed
2.
Zurück zum Zitat Humphries RL, Stone CK, Bowers RC: Colloid cyst: a case report and literature review of a rare but deadly condition. J Emerg Med. 2011, 40 (1): 5-9.CrossRef Humphries RL, Stone CK, Bowers RC: Colloid cyst: a case report and literature review of a rare but deadly condition. J Emerg Med. 2011, 40 (1): 5-9.CrossRef
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Zurück zum Zitat Schwedt TJ, Matharu MS, Dodick DW: Thunderclap headache. Lancet Neurol. 2006, 5 (7): 621-631.CrossRefPubMed Schwedt TJ, Matharu MS, Dodick DW: Thunderclap headache. Lancet Neurol. 2006, 5 (7): 621-631.CrossRefPubMed
Metadaten
Titel
P063. Colloid cysts of the third ventricle: a case report
verfasst von
Silvia de Pasqua
Valentina Favoni
Giulia Giannini
Rossana Terlizzi
Giulia Pierangeli
Pietro Cortelli
Sabina Cevoli
Publikationsdatum
01.12.2015
Verlag
Springer Milan
Erschienen in
The Journal of Headache and Pain / Ausgabe Sonderheft 1/2015
Print ISSN: 1129-2369
Elektronische ISSN: 1129-2377
DOI
https://doi.org/10.1186/1129-2377-16-S1-A131

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