Results of anterior transcallosal approach to pediatric colloid cysts

Abstract

Introduction: Colloid cysts represent 0.5-1% of all intracranial neoplasms and 55% of the third ventricular lesions. In this study, we emphasized the principles of treatment in pediatric cases with third venricular colloid cysts treated by using anterior interhemispheric transcallosal approach.Materials and Method: The patients aged 16 years and below with colloid cysts, operated between 2001-2009, were evaluated retrospectively.Results: There were 3 males and 1 female patients aged between 12-16 (mean age 13.75) years. The mean duration of symptoms were 2.5 months and mean duration of follow-up 46.75 (15-102) months. All the patients had frontal headache as a main complaint; 2 patients also had nausea and vomiting; and 1 patient also had numbness on the left side of his body. Three patients had bilateral marked papil edema while 1 patient had no neurological deficit. Cyst was hyperintense and hypointense in cranial computed tomography of 2 and 1 patients, respectively. T1-, and T2-weighted cranial magnetic resonance images were iso-, and hyperintense in 2 patients while hypo-, and hyperintense in 1 patient, while hyper-, and isointense in 1 patient respectively. Interhemispheric-transcallosal-transforaminal approach was used in all patients. In 3 patients, total excision was performed while in 1 patient, a small part of capsule attached to thalamostriate vein was left. There were no cyst recurrences at follow-up.Conclusions: Although various approaches had been described to reach the third ventricular colloid cyst; we preferred the transcallosal approach in all of our pediatric patients since the approach does not cause any cortical breach and provides secure tumour resection.