Kapu Ravindranath, Symss Nigel Peter, Pande Anil, Vasudevan Matabushi Chakraborthy, Ramamurthi Ravi
Department of Neurosurgery, Post Graduate Institute of Neurological Surgery, Dr. A. Lakshmipathi Neurosurgical Centre, VHS Hospital, Chennai, Tamil Nadu, India.
J Pediatr Neurosci. 2012 May;7(2):90-5. doi: 10.4103/1817-1745.102563.
Colloid cysts are congenital benign lesions, associated with more aggressive clinical and radiological picture in children than in adults. We present our experience in management of five pediatric patients with colloid cyst of the anterior third ventricle. They have an excellent chance of surgical cure, or they can be devastating and even fatal, if not recognized on time and treated.
Five pediatric patients (aged 16 years or less) who were surgically treated for a colloid cyst, between 1987 and 2011 were analyzed. The clinical features included raised intracranial pressure in all five cases, of which one patient was brought unconscious with decerebrate posturing. Computed Tomography (CT) scan of the brain was done in all patients. The density of the lesion, enhancement with contrast and the presence of hydrocephalus were analyzed. Four patients underwent a detailed postoperative neurological assessment.
Three patients underwent the transcallosal-transforaminal approach and total excision of the lesion. One patient underwent revision of the pre-existing ventriculoperitoneal shunt. One patient who was brought in an unconscious state, an external ventricular drain was inserted and she was ventilated. She died 4 hours after the admission. On follow-up, none of the three patients who underwent the transcallosal-transforaminal approach had disconnection syndromes or behavioral disturbances.
Colloid cysts in children are rarer and more aggressive than their adult counterparts. It is surgically curable. Early detection and total excision of the lesion is a permanent cure with minimum morbidity, when compared with the natural history of the disease. The limited anterior callosotomy does not result in disconnection syndromes or behavioral disturbance.
胶样囊肿是先天性良性病变，与成人相比，儿童患者的临床和影像学表现更为凶险。我们介绍对5例第三脑室前部胶样囊肿患儿的治疗经验。如果未能及时识别并治疗，这类囊肿虽然有手术治愈的良好机会，但也可能造成严重后果甚至致命。
分析1987年至2011年间接受手术治疗的5例（年龄16岁及以下）胶样囊肿患儿。临床特征包括所有5例均有颅内压升高，其中1例患儿呈去脑强直姿势昏迷入院。所有患儿均行头颅计算机断层扫描（CT）。分析病变密度、强化情况及脑积水情况。4例患儿术后进行了详细的神经功能评估。
3例患儿采用经胼胝体-经室间孔入路并完整切除病变。1例患儿对已有的脑室-腹腔分流管进行了修复。1例昏迷入院的患儿，置入了脑室外引流管并进行了通气支持。患儿入院4小时后死亡。随访发现，采用经胼胝体-经室间孔入路的3例患儿均未出现分离综合征或行为障碍。
儿童胶样囊肿比成人更为罕见且病情更凶险。该病可通过手术治愈。与疾病自然进程相比，早期发现并完整切除病变可实现永久性治愈且并发症最少。有限的胼胝体前部切开术不会导致分离综合征或行为障碍。
