Isolated entrapment of the lateral ventricle after neuroendoscopic resection of colloid cysts: single - center experience and management

Clin Neurol Neurosurg. 2023 Sep:232:107890. doi: 10.1016/j.clineuro.2023.107890. Epub 2023 Jul 13.

Abstract

Background: A minimally invasive option of colloid cyst surgical treatment is endoscopic resection, well validated in various reports and clinical practice. A rare complication of the surgical treatment, previously reported only once in literature, is the entrapment of the lateral ventricle. In this study we aim to outline our experience in the management of this occurrence, hypothesizing possible etiopathogenetic causes.

Methods: Among patients who underwent neuroendoscopic resection for a colloid cysts at our Institution between 2013 and 2022, cases who developed a postoperative lateral ventricle entrapment were retrospectively reviewed and included. Clinical history, imaging and treatment were reported.

Results: Among 34 patients treated for a colloid cysts, two (5.9 %) patients developed an ipsilateral ventricular entrapment with dilation from two to five months after the resection. Both patients were substantially asymptomatic and neurologically intact, and therefore treated conservatively. One case underwent complete spontaneous radiological resolution one month later, and the other one has remained neurological asymptomatic at follow-up.

Conclusions: Isolated asymptomatic ventricular entrapment with significant dilation after endoscopic colloid cyst resection is a rare occurrence which can be plausibly caused by scar tissue at the level of the foramen of Monro. Because they can have an indolent course with spontaneous resolution, conservative treatment is a viable option, with strict radiological and clinical follow - up. Given the rarity of the occurrence, further studies with larger cohorts are warranted to confirm the etiopathogenetic hypothesis and validate the clinical management.

Keywords: Colloid cyst; Complication; Endoscopy; Entrapment; Hydrocephalus.

MeSH terms

  • Colloid Cysts* / diagnostic imaging
  • Colloid Cysts* / surgery
  • Humans
  • Lateral Ventricles
  • Neuroendoscopes
  • Neuroendoscopy* / adverse effects
  • Retrospective Studies