Colloid cyst of the third ventricle of the brain. Colloid cysts of the third ventricle Colloid cyst of the third ventricle

21.10.2019 -

Ovarian retention cysts. These formations do not belong to true tumors; they are often called tumor-like formations. They can occur in utero in fetuses and newborn girls. However, more often retention cysts occur in girls during puberty and can be caused by a violation of the subthalamic (hypothalamic) - pituitary regulation of ovarian function.

Both follicular and luteal ovarian retention cysts are usually not large and do not exceed 3-4 cm in diameter.

Cystadenoma , or cystoma - a true ovarian tumor - a space-occupying formation with a pronounced capsule, epithelial lining; unlike ovarian cysts, it is capable of proliferation and blastomatous growth (malignancy).

4. Ovarian retention cysts

Ovarian cysts are predominantly retention. They develop from follicles and corpora lutea.

There are two main theories of the occurrence of ovarian retention cysts.

The first theory explains their appearance by changes associated with inflammation of the uterine appendages (51.6% of cases). Congestive hyperemia of the pelvic organs and the development of perio-oophoritis are of great importance. In addition, hyperemia is observed under physiological conditions in connection with the menstrual cycle (ovulation, the developmental phase of the corpus luteum), pregnancy, childbirth, the postpartum period and lactation; reasons may be interrupted sexual intercourse , failure to achieve orgasm with severe sexual arousal, as well as uterine tumors (fibroids) in 34.2% of cases.

The second theory is hormonal - a hormonal imbalance in the patient’s body.

The development of cysts can occur in various ways. In some cases, there is a violation of the relationship between LH and FSH, an increase in FSH, ovulation disorders with follicular cysts (lack of luteinizing hormone in the body), and cysts corpus luteum develop with excess production of luteinizing hormone by the pituitary gland. In other cases, cysts arise against the background of congestive hyperemia, in third cases, the tunica albuginea of the ovary thickens, as a result of which the mature follicle cannot open.

Highlight:

Follicular cysts.

Corpus luteum cyst.

Paraovarian cyst.

Thecal lutein cysts.

Endometrioid cyst.

5. Clinic, diagnosis and principles of treatment of ovarian cysts

Follicular ovarian cyst

This is a single-chamber formation, which arose due to the fact that the Graafian follicle did not open; its cavity is filled with a clear liquid, which is a product of the vital activity of granulosa cells

The presence of a follicular cyst does not disrupt the processes of egg maturation and ovulation in the remaining follicles.

Follicular cyst is observed most often. When small in size, it is asymptomatic, can reach a size of up to 10 cm in diameter, round in shape, single-chamber, with a smooth surface, tight-elastic consistency, thin-walled, mobile, painless on palpation, has a stalk, can spontaneously burst and often ruptures during bimanual examination.

Diagnosis is based on data from a bimanual ultrasound examination (a thin-walled, hypoechoic formation measuring from 3 to 10 cm is visualized in the ovary).

Corpus luteum cyst

Corpus luteum cysts, unlike follicular cysts, are much less common. Their development is due to the fact that after ovulation the follicle cavity does not collapse and is not filled entirely with luteal cells, as is normal, but remains to exist and is stretched with serous fluid. The cyst wall consists of several rows of luteal and thecaluteal cells. As the cyst grows, atrophy of the luteal cells and cystic elements of the inner wall occurs. Corpus luteum cyst is hormonally inactive.

The cyst is usually unilateral, small sizes- 3-4 cm in diameter, tight-elastic consistency, painless. The section shows a scalloped yellow or orange color. The luteal tissue of the cyst undergoes the usual cyclic changes for the corpus luteum. In this regard, during the vascularization phase of the corpus luteum, bleeding occurs into the cyst cavity. As a rule, the cyst appears and enlarges in the 2nd phase of the menstrual cycle.

Symptoms of early pregnancy occur - delayed menstruation, engorgement of the mammary glands; During vaginal examination, an increase in the size of the uterus and the appearance of blood discharge from the genital tract are noted. At this stage, it is necessary to carry out a differential diagnosis with pregnancy, both uterine and ectopic. The diagnosis is clarified by testing urine for hCG, which is not detected with a corpus luteum cyst. To make a diagnosis, as a rule, a bimanual examination and ultrasound are sufficient.

Waiting tactics. As a rule, corpus luteum cysts and follicular cysts undergo reverse development. If this is not observed within 2-3 months or there is a tendency for the cyst to enlarge, an operation is indicated during which resection of the ovary is performed within healthy tissue. Corpus luteum cysts, like follicular cysts, can recur.

Thecal lutein cysts

Thecal lutein cysts are formed under the influence of the stimulating effect of human chorionic gonadotropin, which contains a large amount of luteinizing hormone, on follicular leakage. They are bilateral, reach gigantic sizes, and are companions of diseases such as trophoblast diseases. As the underlying disease is treated, thecal lutein cysts resolve and therefore cannot be treated surgically.

Paraovarian cyst

A paraovarian cyst is formed from the epiophoron - the supraovarian appendage (paraovary), a remnant of the mesonephric duct.

The cyst is most often single-chamber, thin-walled, located interligamentously, the contents are transparent, liquid, poor in proteins, and do not contain mucin. In terms of volume, a paraovarian cyst can range from several centimeters in diameter to the size of a newborn’s head. The shape is spherical or ovoid. The ovary is not involved in the pathological process; the fallopian tube is most often spread out on the surface of the cyst. The wall of a paraovarian cyst consists of connective tissue, the inner surface is smooth, lined with single-layer columnar or squamous epithelium.

It usually occurs at the age of 20-30 years and accounts for about 10% of all tumors and tumor-like formations of the ovary. If the cyst is small, it does not manifest itself in any way. With significant sizes, symptoms appear - pain in the lower abdomen and sacrum, dysuria. The cyst develops slowly, malignancy is extremely rare. Bimanual examination reveals a cystic formation with limited mobility due to its intraligamentary location. At the lower pole of the cyst, it is sometimes possible to palpate the ovary. The diagnosis is confirmed by ultrasound examination(a tumor-like hypoechoic (liquid) formation is detected next to the ovary).

Treatment

Treatment of the cyst is surgical, since parovarian cysts do not undergo reverse development. The operation consists of enucleating the cyst. The fallopian tube and ovary are preserved. There are no recurrences of paraovarian cysts. The prognosis is favorable.

2010-06-25 15:32:11

Elena asks:

Good afternoon I am 27 years old. A month ago I was admitted to the hospital with bleeding and underwent surgical curettage. I did an ultrasound and the conclusion was endometrial hyperplasia and small uterine fibroids. Histology results: endometrioid endometrial hyperplasia, focal endometritis. I also took a tank test from the vagina and uterine cavity, but there are no results yet. This hospital recommends treatment hormonal drug Yarik or Nova-Ring. At the same time, they did not take a hormone test from me.
A year ago I gave birth. Pregnancy and childbirth passed without complications. The child was born weighing 4 kg. The first period came after a year and 1 month and immediately bleeding.
I also had 2 juvenile hemorrhages at age 14. At the age of 17, I had surgery to remove a parovarian ovarian cyst, and I also had polycystic disease of the left ovary. After this, I injected progesterone intramuscularly for some time before my period. After menstrual cycle more or less regulated. Special problems did not have. Got pregnant without problems.
Please tell me how I should be treated and which of these drugs is preferable?

Answers Lishchuk Vladimir Danilovich:

Dear Elena! I can only advise that you need to take one of the contraceptive drugs with therapeutic purpose. Which one specifically? This can only be decided by the doctor who is observing you. There are many options.

2010-06-23 17:53:27

You can't ask:

My mother’s ovarian cyst burst and there was no bleeding. There was just some kind of brown color that I don’t even know. She went to the gynecologist for an ultrasound. Is it dangerous if it bursts, the cyst and fibroids will not become cancer later??? Tell me please???

Answers Lishchuk Vladimir Danilovich:

Your mother most likely had the so-called functional cyst. These formations belong to pseudotumor formations. There is no danger of developing cancer, but you need to be under the supervision of a gynecologist because this is a sign of impaired ovarian function.

2010-06-21 11:20:11

Olga asks:

4th day after laparoscopy of bilateral ovarian cysts (5 cm and 8 cm) diagnosis of endometriosis, I have not given birth or become pregnant for 39 years, they offer hormone injections for 3 months (menopause) - I’m afraid of the consequences - obesity, hair loss and bone collapse, very I'm afraid I can't make a decision if I even have a chance of getting pregnant

Answers Kushniruk Natalya Sergeevna:

Dear Olga,
it all depends on your plans: to engage in infertility treatment or not? Try injecting 3.75 mg instead of a dosage of 11.25 mg of GnRH agonist with a review of the ultrasound 27 days after the injection. It is very difficult to assess your chances of pregnancy without seeing your uterus, ovaries, hormone levels, and sperm count.
Everything needs to be decided directly at the reception.
The only thing that can be said for sure is that there is no time to waste. As soon as you are discharged, make an appointment at the reproductive medicine clinic.
Sincerely, Natalya Sergeevna Kushniruk.

2010-06-19 20:05:54

Alexa asks:

Hello! I ask you to suggest methods of treatment. You know more than our city doctors and I have been convinced of this more than once. My mother is 51 years old and has had a large ovarian cyst of 200 ml for 3 years already. The doctors wanted to cut, but her heart could not stand it .Cancer cells (CA-125) were higher than normal. A herbalist helped. I drank natural drops, herbal tinctures, etc. Now the cyst has decreased to 100 ml in 1.5 years. But fluid has appeared in the abdominal cavity (where the ovaries are). It was seen using an ultrasound, 7-10 ml in volume. It is difficult to get to a herbalist, but good specialist We can’t find a doctor. In a couple of days we’ll get tested again for CA-125. Tell me, what kind of liquid could this be??? Thanks for any help.

Answers Kaliman Viktor Pavlovich:

Good afternoon
CA-125 is one of the tumor markers. It must be taken according to indications and as prescribed by a doctor.
The fluid that is located in the pouch of Douglas can be of various etiologies. Therefore, you need to consult a doctor.

2010-06-15 15:35:10

Klopot Kristina asks:

Hello, I had a follicular ovarian cyst, I cured it, but I haven’t been able to get pregnant for 2 years now, what do I need to take, what medicine should I take, thank you

Answers Medical consultant of the website portal:

Good afternoon, Christina. First you need to find out why pregnancy does not occur. To do this, you need to consult a fertility specialist. You and your husband must undergo the examination. Only then can any treatment be discussed.

2010-06-13 08:07:31

Natalie asks:

Tell me, please, how can an endometrioid ovarian cyst (size 19x24mm) be cured? Is the treatment option appropriate? hormonal contraceptive Janine?

2010-06-12 22:00:57

Inna asks:

Good afternoon. On April 9, I had a laparoscopy (ovarian cysts were removed). After that, my period was on April 15th. I didn’t have my period in May, I thought I was pregnant, I went to the hospital, but the doctor said no. Still no period. What's the matter. I'm already worried.

2010-06-01 08:06:05

Elena asks:

A month and 10 days ago I had an operation to remove the uterus and left ovary due to uterine fibroids and ovarian cysts. I feel normal. Great fear of having sex. Please explain what I need to be afraid of and what I shouldn’t? When can I start? sex life after surgery without harm to health?

2010-05-31 16:41:32

Olga asks:

Hello! I have a left ovarian cyst that has not resolved for 5 months after its treatment. That month the cyst was 5 cm in size, this month it’s already 62*60mm changed due to liquid formation. I am 24 years old, I have not given birth yet, my husband and I really want a child, please tell me whether it is possible to get pregnant with an ovarian cyst and what the consequences may be, thank you very much in advance.

Answers Vengarenko Victoria Anatolevna:

Olga, of course, you must first remove or cure the cyst, and then plan a pregnancy, otherwise there may be torsion or rupture of the cyst (ovarian apoplexy)

News on the topic: ovarian cyst 3 cm

Ovarian cysts are cavity sacs filled with fluid. Cysts in the ovaries can be single or multiple. Very often this disease occurs without clinical manifestations or symptoms. Sometimes women have obvious clinical symptoms, which are very important to recognize in time in order to immediately address to the right specialist

Severe pain in the abdominal area, bloating and other symptoms forced a 66-year-old Hong Kong resident, who had considered himself a man all his life, to consult a doctor. He very quickly discovered that the patient had... an ovarian cyst. But the main “surprise” awaited the patient ahead.

Colloid cyst of the third ventricle - dysembryogenetic benign education with epithelial lining and colloidal contents (Fig. 1830, 1831), sometimes with a tendency to increase and, as a consequence, occlusion of the foramina of Monroe with the development of hydrocephalus.

Fig. 1830, 1831

Epidemiology

1-3% of all intracranial formations. Peak age of detection is 30-40 years.

Morphology and localization

A colloid cyst of the third ventricle is a rounded volumetric formation with clear contours, always located in the third ventricle near the foramina of Monroe. Colloid cysts contain mucin, blood derivatives, cholesterol, which, depending on the content of these substances, determines the signal on MRI (↓T1, as well as ↓or → T2 and Flair) and density on CT (usually).

Rice. 1834, 1835 and 1836. A rounded formation with clear contours, a capsule and homogeneous liquid contents (arrow head in Fig. 1834), located in the third ventricle at the foramen of Monro, having an MR signal in T2 and ↓ in T1 (arrow in Fig. 1835 ), slightly higher than the intensity of the MR signal from the cerebrospinal fluid, causing obstructive hydrocephalus and dilatation of the lateral ventricles (arrowheads in Fig. 1836). On CT, the colloid cyst has a high density (arrow in Fig. 1836). Note the decrease in periventricular density white matter(arrowheads in Fig. 1836) due to transependymal impregnation cerebrospinal fluid due to increased intraventricular cerebrospinal fluid pressure against the background of outflow disturbance caused by the cyst.

When using PI T1 with suppression of the signal from fat, there is no change in the signal intensity from the colloid cyst. After IV enhancement, there is no accumulation of contrast, but contrast in the adjacent subependymal veins may simulate its accumulation in the walls of the cyst.

A colloid cyst of the third ventricle is always identified in its typical location - in the third ventricle, at the interventricular foramen of Monroe (arrowhead in Fig. 1837, 1839). If there is an MR signal from it along T1 (arrowhead in Fig. 1838), which is due to the nature of the contents, it retains the same signal even when gradient fat suppression is added (arrow in Fig. 1838).

Differential diagnosis

Ependymoma

Fig.1840-1842

Ependymoma in the lumen anterior horn right lateral ventricle(arrow in Fig. 1840), has a non-characteristic localization for a colloid cyst of the third ventricle, the intensity of the MR signal is similar to the brain, and also accumulates a contrast agent (arrow head in Fig. 1841, 1842) after intravenous enhancement.

Metastasis to the septum pellucidum

Metastases are well contrasted and are accompanied by perifocal edema. If metastatic brain damage is suspected, priority should be examined: lungs, kidneys, skin, bladder, mammary gland and gastrointestinal tract. Also, in order to find the source and assess the generalization of the tumor process, it is worth deciding on conducting scintigraphy or PET-CT.

Fig.1843-1845

Formation in the area of the transparent septum (arrow in Fig. 1843), accompanied by perifocal edema of the surrounding areas of the brain (arrowhead in Fig. 1843). After intravenous contrast enhancement, this formation intensively accumulates contrast (arrows in Fig. 1844, 1845).

Giant cell astrocytoma

Hamartoma of the gray tuberosity

Lipoma

In the area of the anterior horn and foramen of Monroe of the lateral ventricle, in Bourneville-Pringle disease, in 17% of cases, an astrocytoma is found, while there are other brain changes characteristic of tuberous sclerosis.

Abnormal heterotopia in the area of the gray tuberosity (hamartoma), isointense to the brain in any IP. Lipoma in the area midline structures has MR signal changes characteristic of fat.

Fig.1846-1848

Nodes of giant cell subependymal astrocytoma (arrow head in Fig. 1846), hypothalamic hamartoma in the area of the papillary bodies (arrow in Fig. 1847), as well as a lipoma with a T1 MRI signal in the chiasmatic-sellar region (arrow head in Fig. 1848) .

Pilocytic astrocytoma

Fig.1849-1851

Space-occupying formation represented by pilocytic astrocytoma, in the form of heterogeneous structure is determined in the third ventricle (arrow head in Fig. 1849), intensively accumulating the contrast agent (arrow in Fig. 1851). Note the large cyst in the basal ganglia on the right (asterisk in Fig. 1850).

Clinical picture, treatment and prognosis

In the vast majority of cases, colloid cysts are asymptomatic and are discovered accidentally. Their position in the roof of the third ventricle, immediately adjacent to the foramen of Monro, can lead to sudden obstructive hydrocephalus, and may manifest as headache and loss of consciousness. Headaches tend to depend on the location of the mass, and patients may know how to relieve symptoms (forced positioning). Education growth is slow.

Colloid cyst in the area of the left interventricular foramen (arrow in Fig. 1852), leading to expansion of the left lateral ventricle (arrow head in Fig. 1852). Colloid cyst of the third ventricle (arrows in Fig. 1853, 1854), enlarged during pregnancy, complicated by hydrocephalus (arrowheads in Fig. 1854).

Treatment consists of surgical removal. An osteoplastic craniotomy is performed and the formation is removed through the wall of the lateral ventricle. There are no postoperative relapses.

Closure of one or both foramina of Monroe leads to an increase in cerebrospinal fluid pressure in the cavities of the lateral ventricles, which leads to their dilation, which can be assessed on CT or MRI.

Literature

Gaidar B.V., Rameshvili T.E., Trufanov G.E., Parfenov V.E. Radiation diagnostics of tumors of the brain and spinal cord. practical guide. - St. Petersburg. Folio,
- 336 p.
Kornienko V. N., Pronin I. N. Diagnostic neuroradiology: in 3 volumes. - T. 3. - M., 2009. - 462 p.

– a round-shaped neoplasm, which is located in the cavity of the third ventricle of the brain. Is not cancerous tumor, does not metastasize, but is capable of growth. The danger for the patient lies in blocking the cerebrospinal fluid circulation pathways with the development of hydrocephalic syndrome. At small sizes it does not show itself in any way. With progressive growth it is characterized sudden attacks headaches with vomiting, tinnitus, blurred vision, weakened memory. Diagnosed using CT and MRI images. Treatment is predominantly surgical - removal of the entire cyst and restoration of current cerebrospinal fluid.

General information

Colloid cyst of the third ventricle is benign neoplasm, which is located in the anterior superior part of the third ventricle of the brain. It has a spherical shape, surrounded by a dense capsule of connective tissue; the contents are a green-gray jelly-like mass, which is a secretion product of cyst wall cells. The size of the tumor depends on the duration of the course pathological process, in some cases, the cyst can occupy almost the entire cavity of the brain ventricle.

Pathology does not belong to the category malignant tumors, that is, it does not metastasize, but the neoplasm is capable of progressive growth, and therefore poses a danger to the patient’s life. This type of cyst is quite rare and accounts for approximately 1% of all brain tumors. Colloid cysts of the brain can be found in patients of any age, and occur with equal frequency in men and women.

Causes

The causes of colloid cysts of the third ventricle are still unknown to medicine. Some researchers suggest that their formation is the result of a developmental disorder nervous system in the prenatal period. Before the formation of the cerebral hemispheres, the human embryo has a special outgrowth (primordium) nerve tissue, which resolves during individual development and is absent from the fetus at the time of birth. The process of normal brain growth is disrupted by the negative influence of various external factors during pregnancy: ecology, bad habits, stress; development of severe toxicosis; the occurrence of intrauterine infection or Rhesus conflict in early stages pregnancy. A section of embryonic tissue remains, its cells begin to produce a jelly-like liquid, which is delimited by a dense connective tissue membrane - this is how a colloid cyst of the third ventricle is formed.

Initially, the size of the neoplasm does not exceed a few millimeters. When exposed to provoking factors, the colloid cyst of the third ventricle begins to rapidly increase. That is the real reason The growth of the cyst has not yet been determined. There are suggestions that stress, lack of sleep, obesity, and bad habits contribute to this.

Pathogenesis

The brain is not a solid mass nerve cells, in its cavity there are several voids called ventricles. CSF circulates in them - cerebrospinal fluid. There are 4 ventricles of the brain: I and II (also called lateral), III, IV. All of them make up the circulation paths of the cerebrospinal fluid and are connected to each other by openings. Cerebrospinal fluid is produced by special clusters of tiny blood vessels located on the walls of the ventricles of the brain. U healthy person CSF flows freely from one ventricle to another. As the colloid cyst grows, its circulation channels close, and it cannot pass from the third to the fourth ventricle. Fluid accumulates and increases intracranial pressure.

If height cystic formation does not go towards the connection of the channels, then the increase in intracranial pressure occurs gradually, and the symptoms of the disease manifest themselves for a long time (up to 10 years). With the rapid growth of a neoplasm in the area of the anatomical openings of the cerebrospinal fluid circulation or with a sudden shift of the cyst, symptoms of acute blockage of the cerebrospinal fluid ducts develop.

The peculiarity of the location of the colloid cyst in the cavity of the third ventricle leads to the fact that as the size of the latter increases, pressure occurs on the fornix of the brain and the nuclei of the hypothalamus, this leads to a disruption in the process of remembering recent events ( short term memory), impaired regulation of body temperature, sleep and wakefulness, complete loss of hunger (anorexia) or, conversely, satiety (bulimia), change emotional sphere.

Symptoms

A colloid cyst of the third ventricle in itself does not pose a danger to the patient’s health. Clinical manifestations depend solely on its size. This explains the fact that small cysts that a person has from birth do not affect their health. The danger of neoplasms lies in their progressive growth.

All clinical manifestations the pathological process can be divided into 3 groups: symptoms of acute blockage of the cerebrospinal fluid circulation pathways; symptoms of a gradual increase in intracranial pressure - hydrocephalic syndrome; disorders of higher brain functions - short-term memory, mental abilities, as well as the development of metabolic disorders.

Symptoms of acute blockage of the cerebrospinal fluid ducts represented by an acute increase in intracranial pressure. It is characterized by a sudden unbearable headache, tinnitus, loss of consciousness, convulsions, and in some cases the patient may fall into a coma.

For gradual increase in intracranial pressure The following symptoms are typical: headache, vomiting, blurred vision, convulsions.

Headache with hydrocephalic syndrome has the following features: it intensifies in a lying position, after sleep in the morning, is not relieved by popular painkillers, is accompanied by nausea, vomiting, and, less often, depression of consciousness (drowsiness).

Vomiting with increased intracranial pressure, as a rule, is uncontrollable and does not bring relief, which distinguishes it from vomiting, for example, with food poisoning; often occurs at the height of a headache attack.

Disc swelling optic nerve develops as a result of the pressure of cerebrospinal fluid accumulated in the subarachnoid space. This leads to visual impairment: the patient complains of shadows (floaters) before the eyes, flickering flashes of light. Visual acuity initial stages the disease is not changed, but if the increase in intracranial pressure is chronic, then gradual atrophy of the optic nerve develops, manifested by a progressive decline in visual acuity up to blindness.

Convulsions can be either generalized, when the patient’s entire body shakes, or partial, when twitching is observed in individual muscles, for example, isolated cramps of the arm or leg. Long-term increases in intracranial pressure have negative impact on cortex brain, which leads to disruption of higher brain functions: decreased intelligence, loss of short-term memory.

Frequent manifestations of colloid cysts of the third ventricle are occlusive crises - short-term blockage of the cerebrospinal fluid ducts. This can be observed when the body of the cyst suddenly shifts in the cavity of the ventricle of the brain and the outflow of cerebrospinal fluid is blocked. After a short time, normal circulation is restored and the symptoms disappear. Occlusive crises are characterized by a sudden sharp headache, accompanied by redness of the face, palpitations, increased breathing, fever or, conversely, chills, arrhythmic pulse, jumps blood pressure. All this can occur against the background of sudden weakness and loss of muscle tone in the arm or leg.

Diagnostics

If a colloid cyst of the brain is suspected, the neurologist should refer the patient for the following examinations: MRI of the brain with contrast, CT scan of the brain, consultation with an ophthalmologist. Usually these methods are sufficient to establish the correct diagnosis.

In the pictures computed tomography A colloid cyst looks like a round, whitish formation, which is located in the cavity of the third ventricle of the brain, which appears black on an x-ray. The color of the cyst tissue is much more intense than the neighboring brain tissue, which has a grayish tint in the photographs.

Consultation with an ophthalmologist is necessary to conduct an ophthalmoscopy to assess the condition of the fundus - whether there is swelling of the optic discs, and to determine the condition of the retina. During diagnosis, a colloid cyst of the third ventricle must be differentiated from a pituitary adenoma, freeing the cerebrospinal fluid tract and thereby eliminating the syndrome of increased intracranial pressure. The following surgical techniques are used: craniotomy and endoscopic removal. Craniotomy - opening of the skull and surgery open brain, it allows you to completely remove the tumor, examine the cavity of the third ventricle, and restore the liquor pathways. Its disadvantages are greater trauma and cosmetic defects after surgery. Endoscopic removal of a colloid cyst is carried out through a small hole in the bones of the skull using a special apparatus, which allows both to examine the cavity of the third ventricle and to remove the tumor.

Prognosis and prevention

The prognosis of the disease for small-sized cystic formations that are not prone to growth is favorable. It does not affect the patient's well-being in any way. Untreated growing cysts have a poor prognosis. Hydrocephalus develops, which can cause the death of the patient due to disruption of the heart and breathing when the brain is pressed into the natural anatomical openings of the skull and vital centers are pinched in them. Characterized by memory impairment and the development of acquired dementia. Coma and death of the patient are possible with acute blockage of the cerebrospinal fluid ducts.

After surgery to remove a cystic formation and restore the flow of cerebrospinal fluid modern methods observed practically full recovery sick. In rare cases, the pathological process recurs, and then a repeat operation becomes necessary.

Since a colloid cyst of the third ventricle presumably occurs as a result of intrauterine development disorders, to prevent its occurrence it is necessary to avoid self-medication with any medicines, give up bad habits, follow a sleep schedule, take multivitamin complexes. To prevent the onset of colloid cyst growth in adults, it is necessary to healthy image life.

Most brain cysts are asymptomatic and rarely cause headaches. If symptoms of a brain cyst appear, the most common complaint will be headache. Symptoms of a brain cyst most often appear in patients in adulthood in the form of headache, signs of increased intracranial pressure, acute occlusive hydrocephalus due to the lateral ventricles of the brain.

Other symptoms of a brain cyst include changes mental status patient, nausea and vomiting, epileptic seizure, dizziness, sudden weakness in the legs. The latter manifestation (weakness in the legs) can rarely be associated with other brain tumors and may be a consequence of stretching of the corticospinal tract (fibers going to the legs) as hydrocephalus increases.

In the most severe cases of brain cysts, sudden death occurs. This can happen due to mechanical pressure brain cyst on the regulatory center heart rate located in the hypothalamus. An acute block of cerebrospinal fluid (CSF) with a herniation (herniation) of the brain into the tentorium of the cerebellum can also cause death in a patient with a brain cyst.

Differential diagnosis of colloid cyst of the brain in the region of the 3rd cerebral ventricle

Differential diagnosis of a colloid cyst of the brain should be carried out with wide range tumors of the 3rd cerebral ventricle. These tumors usually arise outside the 3rd ventricle and are able to protect its lumen from external compression by the brain parenchyma. At the same time, these tumors themselves can cause a block of cerebrospinal fluid (CSF). Choroid plexus papillomas occur in the first 20 years of life in the lumen of the 3rd ventricle. Also, 10%-30% of tumors found in the cavity of the 3rd ventricle can enter there from the lateral ventricles through the interventricular foramen of Monroe. Neurocytomas are intraventricular benign tumors of the nervous system, consisting of mature ganglion cells and occurring in children and young patients in the lateral and third ventricles of the brain.

Neurocytomas are often misdiagnosed as oligodendroglioma or ependymoma by light microscopy, so the true incidence of neurocytomas is ( benign tumor nervous system, consisting of mature ganglion cells) may be higher than thought. Intraventricular meningiomas occur in 15%-17% of cases of meningiomas in children, and only in 1.6% of cases of a similar location in meningiomas in adults. By origin, meningiomas can be from the lumen of the lateral ventricles (rarely) or grow from the base of the skull into the bottom of the 3rd ventricle (more often).

As was written above, the main damaging effect on the 3rd cerebral ventricle comes from the surrounding brain parenchyma. The majority of these lesions arise from glial tumors, including pilocytic astrocytomas, fibrillary astrocytomas, protoplasmic astrocytomas, subependymal giant cell astrocytomas, glioblastoma multiforme, and ependymomas. Tumor metastases (neoplasms) can involve the 3rd cerebral ventricle through its roof, floor, side wall or choroid plexus. Metastases from the lungs, colon, kidneys and breasts are most common. In such cases (tumor cell metastases), the prognosis is unfavorable and death occurs as a result of progression of the underlying disease.

Suprasellar germinomas and craniopharyngiomas can invade the bottom of the 3rd cerebral ventricle from below from the base of the skull (middle cranial fossa). A suprasellar located pituitary macroadenoma can also invade the 3rd cerebral ventricle. Reduced acuity and narrowing of visual fields, endocrine pathology and headache is the most frequent symptoms in such cases.

Other cysts in the anterior 3rd ventricle include epidermoid cysts, dermoid cysts, and neurocysticercosis. Epidermoid and dermoid cysts are rare in the third ventricle, and neurocysticercosis is common in Eastern Europe, Asia, Central and South America, Mexico and Africa. The penetration of neurocysticercosis into the 3rd cerebral ventricle is 15%-25% and leads to the subsequent development of hydrocephalus.

Inflammatory lesions such as purulent abscess and granulomatous diseases such as tuberculosis and fungal infection, significantly less often affects the 3rd cerebral ventricle. Other lesions, such as sarcoidosis and histiocytosis, can affect the 3rd ventricle through its floor and hypothalamus.

And finally, vascular lesions of the brain, such as cavernous malformations and arteriovenous malformations should be added to differential diagnosis effects on the 3rd cerebral ventricle.

Diagnosis of a colloid cyst of the brain in the region of the 3rd cerebral ventricle

Magnetic resonance imaging (MRI) of the brain is performed if a colloid cyst is suspected.

The contents of a colloid cyst are determined if it appears during an imaging study. The cyst may be discovered incidentally during a CT scan of the brain, or when a patient has symptoms and signs of increased intracranial pressure that lead the physician to suspect acute obstructive hydrocephalus. Computed tomography (CT scan of the brain) typically shows a homogeneous hyperintense mass within the 3rd ventricle at the level of the interventricular foramen from Monro.

Acute occlusive hydrocephalus with periventricular edema can occur due to a block of cerebrospinal fluid along its path to the 3rd cerebral ventricle. On T2-weighted magnetic resonance images (MRI of the brain), the cyst may be hypo- or hyperintensely stained, and fluid-attenuated inversion recovery (FLAIR) shows periventricular edema in the acute stage hydrocephalus, as hyperintensely stained brain parenchyma surrounding the lateral ventricle.

Treatment of colloid cyst of the brain in the 3rd ventricle area

Surgery is indicated after evaluating factors such as the patient's age, symptoms, and the size of the cyst itself. Because of the threat sudden death, surgery is recommended for cysts larger than 1.5 cm in diameter in young patients, even if it is asymptomatic. A symptomatic patient with a brain cyst in the 3rd ventricle should always receive treatment.

Options for surgical treatment of brain cysts in the region of the 3rd cerebral ventricle include both endoscopic removal of the cyst and open operations with various approaches, such as hemispheric transcortical or interhemispheric transcallosal (through corpus callosum) access.