Clinical symptoms and surgical outcome of colloid cysts of the third ventricle: A multicenter retrospective study

Introduction: Colloid cysts of the third ventricle are benign brain lesions that may obstruct cerebrospinal fluid flow within the ventricular system and cause symptoms like headaches, deterioration of vision, and acute hydrocephalus. Research question: What is the clinical outcome of surgical treatment of third ventricle colloid cysts, and what factors are influencing long-term complications? Material and methods: In this multicenter retrospective cohort study performed between 2008 and 2023, we assessed the preoperative clinical status, the colloid cyst risk score, surgical techniques, and the clinical outcome of patients undergoing surgical cyst resection for incidental and symptomatic colloid cysts of the third ventricle. We specifically focused on long-term data such as shunt dependency and postoperative complications. Results: In total, 190 patients were included. Most presented with headaches (75,3%), while 25% showed signs of acute and 36% signs of chronic hydrocephalus. In 23% of the patients, short-term memory was impaired. The surgical treatment presented a safe and definite treatment, with wound healing disorders (6.3%) and CSF leakage (4.7%) being the most frequently encountered complications. Only 5.3% showed a postoperative shunt dependency. Discussion and conclusion: The surgical treatment of colloid cysts of the third ventricle represents a safe procedure. Acute hydrocephalus was observed more frequently than previously described, and shunt dependency after surgery was low.