Department of Neurological Surgery, Hospital Universitario Basurto, Avenida Montevideo 18, 48013 Bilbao (Vizcaya, Basque Country), Spain.
Department of Neurological Surgery, Hospital Universitario Basurto, Avenida Montevideo 18, 48013 Bilbao (Vizcaya, Basque Country), Spain.
Neurocirugia (Astur : Engl Ed). 2021 May-Jun;32(3):142-147. doi: 10.1016/j.neucir.2020.03.006. Epub 2020 May 17.
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.
19-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.
Bleeding 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.
第三脑室胶样囊肿急性自发性出血极为罕见。因此，难以确定可靠的预后因素，梗阻性脑积水的危险因素仍未明确定义，也没有标准的治疗策略。
我们描述了一名 19 岁的男性患者，其第三脑室胶样囊肿引起梗阻性脑积水，最初采用部分内镜切除和脑室-腹腔分流术进行治疗。连续的神经影像学随访显示，由于临床无症状的颅内囊肿内反复出血，囊肿逐渐增大。采用经胼胝体入路显微镜下手术，将囊肿完全切除。病理检查显示肿瘤内有不同时期的出血。
当神经影像学随访显示囊肿生长时，即使没有与临床事件相关，也必须考虑胶样囊肿内出血。在手术指征和方法上应考虑胶样囊肿内的出血性改变。
