Acute hydrocephalus caused by a colloid cyst - a case report

Abstract

Background: Colloid cysts are rare benign, slowly growing intracranial tumors of endodermal origin. Most colloid cysts are found incidentally and are asymptomatic, but rarely, they can lead to sudden death.

Case presentation: A 73-year-old female patient was admitted to our emergency department with complaints of dizziness, nausea, vomiting, fatigue, walking difficulties, and behavioral changes. CT imaging revealed acute obstructive hydrocephalus attributable to a third ventricular colloid cyst. The patient was immediately transferred to a tertiary center where she underwent successful neurosurgical resection of the mass. Pathology results of the lesion confirmed the diagnosis of colloid cyst.

Conclusion: The case we present emphasizes the critical importance of prompt identification of warning signs, complex thinking, and evaluation. Establishing the right diagnostic approach early on can facilitate accurate diagnosis.

Keywords: Acute hydrocephalus; Colloid cyst; Elevated intracranial pressure; Third ventricle.

Fig. 1

Colloid cyst (initial images). Unenhanced CT images show a well-defined hyperattenuating lesion on the anterior roof of the third ventricle at the foramina of Monro causing obstructive hydrocephalus. (A) axial, (B) coronal (C) sagittal reconstruction

Fig. 2

Axial CT image right after surgical resection of the colloid cyst shows pneumocephalus and small amount of intraventricular hemorrhage which can be considered normal postoperative findings. The hydrocephalus has not yet resolved

Fig. 3

MRI images 4 months after surgical resection. T2-weighted sagittal TSE DRIVE (A), T2-weighted axial (B) and coronal (C) MRI images demonstrate a postoperative defect on the roof of the third ventricle. There is moderate residual hydrocephalus with no signs of obstruction. TSE: turbo spin-echo