The patient was brought to ICU in semiconscious state with
progressive deterioration within 2 days. MRI performed today showing
colloid cyst with acute hydrocephalus. Mannitol with decadron
started and within 3-4 hours the patient was operated.
tranfrontal transcortical approach to the right lateral ventricle.
The chocolate fluid was evacuated through syringe without
contaminating the CSF. After that, the ventricles became lax and it
was possible to see the floor of the third ventricle. The cyst had
multicompartment structure, for what it was dealt with caution.
The wall of the cyst was highly vascular and stuck with choroid
plexus and many arterial feeders were coagulated and bisected. Part
of the cyst wall was the thalamic vein, which was preserved to avoid
venous occlusion. Continue next.......!