[01] Guru Dutta Satyarthee, Department of Neurosurgery, Neurosciences Centre, AIIMS New Delhi, India. [02] Shikha Satyarthee, Summer Training, St Stephen’s Hospital, Delhi, India. [03] Amit Handa, Department of Neurosurgery, St Stephen’s Hospital, Delhi, India. [04] Shushil Kumar, Department of Neurosurgery, St Stephen’s Hospital, Delhi, India.

Colloid cyst (CC) is a rare benign intracranial lesion. Detailed symptomatology in the pediatric cases are lacking due to paucity of published papers in the western literature. It usually carries a prolonged course and may present with headache, or rarely with rapid neurological deterioration and extremely uncommon may lead to sudden death. A-10 -year boy presented with progressive headache for three weeks duration and developed alteration of sensorium one day prior to reporting to hospital. In the emergency department, an external ventricular drain was placed and subsequently definitive surgery for colloid cyst was carried out two days later. He recovered well after surgery. Pertinent risk factors and imaging finding to predict such aggressive behaviour and pertinent literature is described briefly.

Pediatric Colloid Cyst, Aggressive Course, External Ventricular Drain, Hyperdense

[01] Hernesniemi J, Leivo S. Management outcome in third ventricular colloid cysts in a defined population; a series of 40 patients treated mainly by transcallosal microsurgery. Surg Neurol. 1996; 45: 2–14. [02] Kelly R. Colloid cysts of the third ventricle: Analysis of twenty-nine cases. Brain 1951; 74: 23-65. [03] Opeskin K, McD Anderson R, Lee KA. Colloid cyst of the 3rd ventricle as a cause of acute neurological deterioration and sudden death. J Paediatr Child Health 1993; 29: 476-7. [04] Urso JA, Ross GJ, Parker RK, Patrizi JD, Stewart B. Colloid cyst of the third ventricle: Radiologic-pathologic correlation. J Comput Assist Tomogr 1998; 22: 524-728. [05] Waggenspack GA, Guinto FC. MR and CT of masses of the anterosuperior third ventricle. AJR Am J Roentgenol. 1989; 152 (3): 609-14. [06] Osborn AG, Preece MT. Intracranial cysts: radiologic-pathologic correlation and imaging approach. Radiology. 2006; 239: 650-64. [07] Kapu R, Symss NP, Pande A, Vasudevan MC, Ramamurthi R. Management of pediatric colloid cysts of anterior third ventricle: A review of five cases. J Pediatr Neurosci 2012; 7: 90-96. [08] Abernathey CD, Davis DH, Kelly PJ. Treatment of colloid cysts of the third ventricle by stereotaxic microsurgical laser craniotomy. J Neurosurg. 1989; 70: 525–529. [09] Colice GL. Neurogenic pulmonary oedema. Clin Chest Med. 1985; Mamourian AC, Cromwell LD, Harbaugh RE. Colloid cyst of the third ventricle: sometimes more conspicuous on CT than MR. AJNR Am J Neuroradiol. 1998; 19: 875–878. [10] Hadley DM. Colloid cyst of the III ventricle. Neurol Neurosurg Psychiatry. 2002; 72: 15–15. [11] Smith WS, Matthay MA. Evidence for a hydrostatic mechanism in human neurogenic pulmonary oedema. Chest. 1997; 111: 1326–1333. [12] Hamlat A, Pasqualini E, Askar B. Hypothesis about the physiopathology of acute deterioration and sudden death caused by colloid cysts of the third ventricle. Med Hypotheses. 2004; 63: 1014–1017. [13] Rosenblum MK. Neuromuscular system: central nervous system. In: Rosai J, editor. Rosai and Ackerman's Surgical Pathology. 9. Vol. 2. Philadelphia: Mosby; 2004. pp. 2467–2468. [14] Pollock BE, Huston J., 3rd Natural history of asymptomatic colloid cysts of the ventricle. J Neurosurg. 1999; 91: 364–369. [15] Partington MW, Bookalil AJ. Familial colloid cysts of the third ventricle. Clin Genet. 2004; 13: 473–475. [16] Satyarthee GD, Mahapatra A. K. Migration and subgaleal coiling of distal components of a V-P shunt in a 2-year boy: Does electrical stimulation as part of physiotherapy is cause or casual association? Romanian neurosurgery 2015; 29 (2): 195-198. [17] Satyarthee Guru Dutta, Satyarthee S. Spontaneous CSF Rhinorrhoea as Presenting Symptom of Neglected Aqueductal of Sylvian Stenosis and Obstructive Hydrocephalus: Management Review American Journal of Clinical Neurology and Neurosurgery 2016; 2: 14-17. [18] Satyarthee G D, Gopal K. Post - Traumatic Thick Acute Subdural Hematoma in Child Showing Rapid Deterioration Managed with Burr - Hole Evacuation Surgery with Drain: A Novel Rescue Technique A J Cli Neurol Neurosurg 2016; 2: 18-21. [19] Pollock BE, Huston J 3rd J Neurosurg. Natural history of asymptomatic colloid cysts of the third ventricle. 1999 Sep; 91(3): 364-9.