Acute spontaneous bleeding within a colloid cyst of the third ventricle is extremely rare. Accordingly, is difficult to establish reliable prognostic factors, risk factors for obstructive hydrocephalus remain poorly defined, and there are no standard management strategies.
Case presentation19-Year-old man with a colloid cyst of the third ventricle causing obstructive hydrocephalus is described, initially treated with partial endoscopic removal and ventriculo-peritoneal shunt placement. Serial neuroimaging follow-up showed gradual growth of the cyst due to clinically silent intracystic recurrent hemorrhage. Microsurgical transcallosal approach was performed and the cyst was totally resected. Pathological examination demonstrated hemorrhages of varying ages within the tumor.
ConclusionBleeding within a colloid cyst must be considered when neuroimaging follow-up shows cyst growth, even with no clinical events associated. Hemorrhagic changes within the colloid cyst should be considered in the surgical indication and approach.
El sangrado espontáneo agudo en un quiste coloide del tercer ventrículo es extremadamente raro. En consecuencia, es difícil establecer factores pronósticos fiables, los factores de riesgo asociados a hidrocefalia obstructiva permanecen mal definidos y no existen estrategias de manejo estandarizadas.
Presentación del casoVarón de 19 años con un quiste coloide del tercer ventrículo e hidrocefalia obstructiva, inicialmente tratado mediante extirpación endoscópica parcial y derivación ventriculoperitoneal. Posteriormente se demostró el crecimiento gradual del quiste debido a hemorragias intraquísticas recurrentes, clínicamente silentes. Se realizó un abordaje microquirúrgico transcalloso con resección completa. El examen anatomopatológico demostró la presencia de hemorragias en diferentes estadios dentro del tumor.
ConclusionesEl sangrado dentro de un quiste coloide debe ser considerado cuando las pruebas de imagen muestran el crecimiento del quiste, incluso en ausencia de eventos clínicos. Los cambios hemorrágicos dentro del quiste coloide deben considerarse en la indicación quirúrgica y abordaje.
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