Third ventricular colloid cysts in children

Introduction: Colloid cysts of the 3rd ventricle are relatively rare intracranial tumours, more so in children. They are benign tumours with excellent prognosis if diagnosed and treated early. Methods: A retrospective analysis of 18 cases of colloid cysts in children below 18 years, operated in our institution between September 1998 and November 2003 (5 years) was made. Clinical presentation, radiological findings, surgical approaches and outcome were analysed. Results: Age ranged from 7 to 18 years. The male-to-female ratio was 12:6. Headache and vomiting were the most common symptoms. Papilloedema was the most common clinical sign. Preoperative CT showed a hyperdense non-enhancing lesion in the majority. Twelve patients underwent a transcallosal, 2 a transcortical and 4 an endoscopic approach. Ventriculoperitoneal shunts were done in 5 patients. Postoperatively 2 patients developed epidural haemorrhage which required evacuation. One patient was reexplored for symptomatic residue. A mean follow-up of 10.2 months was available in 9 patients; the majority were asymptomatic. Conclusion: Colloid cysts though rare are increasingly detected in children. Their early recognition and treatment give excellent results.