ABSTRACT
Endoscopic third ventriculostomy (ETV) is an increasingly common neurosurgical procedure. Hemostatic agentes (porcine gelatin and oxidized cellulose) are normally placed to plug the cortical hole after ETV to avoid cerebral spinal fluid leakage, subdural hygroma, and hemorrhage. Here we report the case of a 6-year-old boy with hydrocephalus who underwent ETV and which oxidized cellulose was placed to plug the cortical hole.Magnetic resonance imaging of the head performed 3 months after the procedure showed the presence of oxidized cellulose in the ventricle. After an unsuccessful attempt to remove the cellulose, it was decided that the patient should be kept under observation. Twoyears later, the child is in good health and without any complaints. Hemostatic agents (especially oxidized cellulose) used on the cortical hole after ETV can migrate to the ventricle and compromise the procedure. Follow-up should be performedfor such patients, and the main focus should be on not causing further injury.
Subject(s)
Humans , Male , Child , Ventriculostomy/methods , Cellulose, Oxidized/therapeutic use , Third Ventricle/abnormalities , Hydrocephalus/complications , Hydrocephalus/diagnostic imaging , Psychosurgery/methodsABSTRACT
Los quistes coloides son lesiones intracraniales con una incidencia calculada en tres individuos por millón de personas en un año. Son tumores benignos de la porción anterosuperior del tercer ventrículo. El flujo normal del líquido cefalorraquídeo puede ser interrumpido por un gran quiste que obstruya el foramen de Monro. Los signos y síntomas asociados engloban un espectro amplio de características, desde una cefalea o específica hasta datos de hipertensión intracraneal; algunos quistes coloides se dan en el comienzo agudo de una hidrocefalia y pueden llevar a una muerte súbita. Caso: presentamos el caso de un adolescente masculino de 13 años de edad, de raza negra, quien dos días antes de su fallecimiento había manifestado cefalea. Al examen de autopsia se evidenció un quiste coloide del tercer ventrículo que produjo una hidrocefalia aguda obstructiva, con edema cerebral severo y herniación de amígdalas cerebelosas. En este artículo comentamos las características principales del quiste coloide y realizamos una breve revisión bibliográfica...
Subject(s)
Humans , Male , Adolescent , Cysts , Intracranial Hypertension/etiology , Third Ventricle/abnormalities , Third Ventricle/physiopathology , Costa RicaABSTRACT
Colloid cysts of the third ventricle are rare benign intracranial tumors accounting for less than 1.5% of brain tumors. Two cases, both of young patients presenting with sudden neurological deterioration after a long period during which they complained of intermittent headache and personality changes, are presented in this report. In the first patient the initial working diagnosis made at the district hospital referring the patient was a central nervous system infection and a lumbar puncture was contemplated but not performed. In both patients, urgent brain imaging showed acute obstructive hydrocephalus due to a mass in the area of the third ventricle which later histologically proved to be a colloid cyst. The radiological appearances of the tumor and its consequences were rather unusual in that the third ventricle was also dilated in both cases in addition to the lateral ventricles. A brief discussion of these tumors is presented with emphasis on modes of presentation and radiological appearances