Brainstem death due to intracranial hypertension with hydrocephalus, produced by a third ventricular colloid cyst

Abstract

We describe the clinical presentation and CT findings of a 10 years old female patient about half an hour prior to cardiorespiratory arrest & subsequent death, resulting from brainstem compression & herniation caused by hydrocephalus & intracranial hypertension, produced by a previously undetected colloid cyst occluding foramina of Monro on both sides. While third ventricular colloid cysts are rare lesions, sudden unpredicted deaths have been attributed to undetected colloid cysts in many case reports, with some authors even considering that 10% of colloid cyst patients suffer such ends. However, there is still no conclusive or comprehensive guideline regarding how to prevent such situations. We make a short literature review and put forward a few recommendations / learning points to that end.

Diagnostic Methods in Forensic Pathology: Autoptic Findings and Immunohistochemical Study in Cases of Sudden Death Due to a Colloid Cyst of the Third Ventricle

“…Hypoperfusion of brain tissue causes brain atrophy, permanent brain damage, and possible death, while the formation of brain hernias results in brainstem compression. In particular, transtentorial (uncal) herniation compresses the midbrain and tonsillar herniation of the bulb, causing sudden death due to cardiorespiratory arrest [ 17 , 35 , 36 ].…”