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42 years old, chronic headache
What is the most likely diagnosis?
1.
2.
3.
4.
5.
【Answer】
5.
【Discussion】
Third ventricular colloidal cyst
【Overview】
1.
2.
3.
4.
5.
【Clinical Manifestations】
1.
2.
3.
4.
Headache
5.
Coma
6.
Sudden death
【Imaging Performance】
1.
CT or MRI can be used to diagnose gelatinous cysts
2.
CT
(1) The anterior part of the third ventricle is like a round high-density nodule
(2) Hydrocephalus
3.
MRI
(1) Cyst signaling features are diverse
(2) Generally speaking, cyst T1 has a high signal and T2 has a low to equal signal
(3) No reinforcement
【Treatment】
1.
Hydrocephalus is considered an indication for surgery
2.
Cyst T2 high signal can be used in simpler minimally invasive surgical techniques
【Complications】
1.
Hydrocephalus may still exist after surgery, so it is necessary to insert a ventricular drainage tube (shunt) frequently.
【Prognosis】
Gelatinous cysts can be cured after resection
Third ventricular colloidal cyst:
Axial CT scan (above) shows a high-density nodular shadow in the anterior part of the third ventricle (white arrow), blocking the mongoose hole causing hydrocephalus, the left anterior ventricle corner (yellow arrow) is significantly enlarged than the right anterior ventricle angle (blue arrow), and the lateral ventricular body is dilated (green arrow).
The figure below shows a low signal (white arrow) for nodule T1 and a high signal (yellow arrow)
for T2 FLAIR.
