Frameless Neuronavigation-Guided Endoscopic Total En-Bloc Removal of a Third Ventricular Colloid Cyst: A Case Report on Surgical Technique

Abstract

A 26-year-old man was referred to our department with recurrent episodes of loss of consciousness. The radiological evaluation of the patient's cranium showed a third ventricular colloid cyst with only a slight degree of obstructive hydrocephalus. The complete, en-bloc removal of the cyst was achieved by a frameless neuronavigation-guided endoscopic resection technique. The patient had an uneventful post-operative period and was discharged home on the fourth post-operative day without any neurological or psychological deficit. The surgical technique and pertinent literature are discussed with emphasis on factors that contribute to our successful total en-bloc removal of the third ventricular colloid cyst.

Key words

frameless neuronavigation - endoscopy - surgical technique - colloid cyst

References

• 1 Horn EM, Feiz-Erfan I, Bristol RE, Lekovic GP, Goslar PW, Smith KA, Nakaji P, Spetzler RF. Treatment options for third ventricular colloid cysts: comparison of open microsurgical versus endoscopic resection.  Neurosurgery. 2007;  60 613-618
• 2 Kehler U, Brunori A, Gliemroth J, Nowalk G, Delitala A, Chiappeta F, Arnold H. Twenty colloid cysts-comparison of endoscopic and microsurgical management.  Minim Invas Neurosurg. 2001;  44 121-127
• 3 Decq P, Le Guerinel C, Brugieres P, Djindjian M, Silva D, Keravel Y, Melon E, Nguyen JP. Endoscopic management of colloid cysts.  Neurosurgery. 1998;  42 1288-1294
• 4 Lewis AI, Crone KR, Taha J, Loveren HR van, Yeh HS, Tew  Jr  JM. Surgical resection of third ventricle colloid cysts. Preliminary results comparing transcallosal microsurgery with endoscopy.  J Neurosurg. 1994;  81 174-178
• 5 Desai KI, Nadkarni TD, Muzumdar DP, Goel AH. Surgical management of colloid cyst of the third ventricle - a study of 105 cases.  Surg Neurol. 2002;  57 295-302
• 6 Solaroglu I, Beskonakli E, Kaptanoglu E, Okutan O, Ak F, Taskin Y. Transcortical-transventricular approach in colloid cysts of the third ventricle: surgical experience with 26 cases.  Neurosurg Rev. 2004;  27 89-92
• 7 Jeffree RL, Besser M. Colloid cyst of the third ventricle: a clinical review of 39 cases.  J Clin Neurosci. 2001;  8 328-331
• 8 Powell MP, Torrens MJ, Thomson JL, Horgan JG. Isodense colloid cysts of the third ventricle: a diagnostic and therapeutic problem resolved by ventriculoscopy.  Neurosurgery. 1983;  13 234-237
• 9 Apuzzo MLJ, Chandrasoma PT, Zelman V, Giannotta SL, Weiss MH. Computed tomographic guidance stereotaxis in the management of lesions of the third ventricular region.  Neurosurgery. 1984;  15 502-508
• 10 Heikkinen ER. Stereotactic neurosurgery: new aspects of an old method.  Ann Clin Res. 1986;  18 73-83
• 11 Grunert P, Hopf N, Perneczky A. Framed-based and frameless endoscopic procedures in the third ventricle.  Stereotact Funct Neurosurg. 1997;  68 80-89
• 12 Souweidane MM. Endoscopic surgery for intraventricular brain tumors in patients without hydrocephalus.  Neurosurgery. 2005;  57 ((4 suppl)) 312-318
• 13 Hellwig D, Bauer BL, Schulte M, Gatscher S, Riegel T, Bertalanffy H. Neuroendoscopic treatment for colloid cysts of the third ventricle: the experience of a decade.  Neurosurgery. 2003;  52 525-533
• 14 Gumprecht H, Trost HA, Lumenta CB. Neuroendoscopy combined with frameless neuronavigation.  Br J Neurosurg. 2000;  14 129-131
• 15 Caemaert J, Abdullah J. Endoscopic management of colloid cysts.  Techniques in Neurosurgery. 1995;  3 185-200
• 16 Zohdi A, El Kheshin S. Endoscopic approach to colloid cysts.  Minim Invas Neurosurg. 2006;  49 263-268
• 17 Teo C. Complete endoscopic removal of colloid cysts: issues of safety and efficacy.  Neurosurg Focus. 1999;  6 e9
• 18 Abdou MS, Cohen AR. Endoscopic treatment of colloid cysts of the third ventricle: Technical note and review of the literature.  J Neurosurg. 1998;  89 1062-1068
• 19 Schroeder HW, Wagner W, Tschiltschke W, Gaab MR. Frameless neuronavigation in intracranial endoscopic neurosurgery.  J Neurosurg. 2001;  94 72-79
• 20 Charalampaki P, Filippi R, Welschehold S, Perneczky A. Endoscope-assisted removal of colloid cysts of the third ventricle.  Neurosurg Rev. 2006;  29 72-79

Correspondence