Acute hydrocephalus caused by a colloid cyst — a case report

Abstract

Background Colloid cysts are rare benign, slowly growing intracranial tumors of endodermal origin. Most colloid cysts are found incidentally and are asymptomatic, but rarely, they can lead to sudden death. Case presentation A 73-year-old female patient was admitted to our emergency department with complaints of dizziness, nausea, vomiting, fatigue, walking difficulties, and behavioral changes. CT imaging revealed acute obstructive hydrocephalus attributable to a third ventricular colloid cyst. The patient was immediately transferred to a tertiary center where she underwent successful neurosurgical resection of the mass. Pathology results of the lesion confirmed the diagnosis of colloid cyst. Conclusion The case we present emphasizes the critical importance of prompt identification of warning signs, complex thinking, and evaluation. Establishing the right diagnostic approach early on can facilitate accurate diagnosis.

Colloid Cyst Presenting With Severe Headache and Bilateral Leg Weakness: Case Report and Review

“…Purported causes include not only the ball-valve mechanism hypothesis but also direct stimulation of the hypothalamus from colloid cyst compression [ 10 ]. Acute brain herniation has also been proposed as a cause of sudden death in patients with colloid cysts of the third ventricle [ 11 ]. Physical exertion has been associated with acute presentations of a colloid cyst of the third ventricle [ 3 ].…”

Acute hydrocephalus caused by colloid cyst of third ventricle: A case report

“…CCs of the third ventricle are the most common neuroepithelial cysts [1] . They are congenital lesions of endodermal origin [ 3 , 4 ]. CCs are seen in approximately 3 individuals per million per year [ 1 , 2 ].…”

“…Management of colloid cysts is influenced by age and performance status of the patient, the size of CC, and the presence of hydrocephalus. Small (<10 mm size) nonobstructive CCs can be followed up [ 3 , 4 ]. We should manage complications of acute hydrocephalus too.…”

“…External ventricular drainage was kept within hours to prevent further hydrocephalus and extension of infarct. Management options for large and symptomatic CCs include stereotactic aspiration, endoscopic fenestration, and resection, open surgical resection, and microsurgery [ 4 , 6 , 8 ]…”