Object: The objective of the present study is to analyze the complications and their
avoidance in a series of 80 patients operated by transcallosal transforaminal approach
to colloid cysts of the anterior third ventricle. Materials and Methods: The surgical outcome and complications of 80 patients operated by transcallosal transforaminal
approach for colloid cysts in the anterior third ventricle was analyzed. A detailed
pre- and post-operative neurological assessment was done in all patients. Neurocognitive
assessment of corpus callosal function was done in the last 22 cases. CT scan of the
brain was done in all patients, before and after surgery. Results: All patients underwent transcallosal transforaminal approach. Total excision of the
lesion was achieved in 79 patients and subtotal in one. The complications encountered
were postoperative seizures in six, acute hydrocephalus in four, venous cortical infarct
in four, transient hemiparesis in four, transient memory impairment, especially for
immediate recall in nine, mutism in one, subdural hematoma in one, meningitis in three,
and tension pneumocephalus in one patient. There were two mortalities. There was no
incidence of postoperative disconnection syndrome.
Conclusion: Colloid cyst is surgically curable. With good knowledge of the regional
anatomy and meticulous microsurgical techniques, there is a low mortality and minimum
morbidity, when compared to the natural history of the disease. With increasing experience,
most of the complications are avoidable. The limited anterior callosotomy does not
result in disconnection syndromes.
Key-words:
Anterior third ventricle - colloid cyst - complications - disconnection syndrome -
transcallosal - transforaminal
