Diagnostic Dilemma in a Young Woman with Acute Headache: Delayed Diagnosis of Third Ventricular Colloid Cyst with Hydrocephalus

Abstract

Objectives. To highlight the importance of early diagnosis of colloid cyst of the third ventricle and its early management. Clinical Presentation and Intervention. This is a young lady who presented with sudden onset headache. She attended a local clinic and also her area hospital. Her diagnosis was delayed several hours due to a diagnostic dilemma initially. No surgical intervention was tried since the patient developed early signs of brainstem coning by the time she was seen by neurosurgeon. Patient died after few days in spite of intensive ICU measures. Conclusion. Sudden onset headache in young adults should be looked at carefully. Early imaging is mandatory to prevent mortality.

Diagnostic Methods in Forensic Pathology: Autoptic Findings and Immunohistochemical Study in Cases of Sudden Death Due to a Colloid Cyst of the Third Ventricle

“…Sudden death occurred in about 10% of patients with a third ventricle colloid cyst. Acute deterioration occurs in 34% of cases, with a mortality rate of 12% in the case of a symptomatic colloid cyst [ 18 ]. Fatal intracranial hypertension, obstructive hydrocephalus, and acute lateral ventricle dilatation are due to intermittent or persistent obstruction of Monro’s foramen; however, the compression of the hypothalamus by the cyst can also lead to death, causing a cardiac reflex [ 22 ].…”

A Rare, yet Classic Case of Colloid Cyst of Third Ventricle

“…Sudden death has happened in about 10% of patients with colloid cyst of the third ventricle. Symptomatic colloid cyst of the third ventricle has the highest risk of acute deterioration in 34% cases with a mortality rate of 12% [ 4 ]. Persistent or intermittent obstruction of foramina of Monro can lead to acute lateral ventricle dilatation resulting in hydrocephalus intracranial hypertension, which can be fatal.…”

“…In about 10% of cases of colloid cysts of the third ventricle, sudden death has been reported. Of all cases of sudden death, 0.16-3.2% are caused by brain lesions, of which colloid cyst of the third ventricle is the main contributor [ 4 ]. Of all cases of sudden coma and death, these lesions contribute about 0.001-0.009% [ 4 ].…”

“…Of all cases of sudden death, 0.16-3.2% are caused by brain lesions, of which colloid cyst of the third ventricle is the main contributor [ 4 ]. Of all cases of sudden coma and death, these lesions contribute about 0.001-0.009% [ 4 ]. Due to this reason, identification of this lesion and its rapid management is needed, despite the benign nature and to prevent life-threatening complications.…”