What are the other Names for this Condition? (Also known as/Synonyms)

• Colloid Brain Cyst
• Colloid Cyst of the Third Ventricle
• Intracranial Colloid Cyst

What is Colloid Cyst of Brain? (Definition/Background Information)

• Colloid Cyst of Brain is a benign cyst that is observed in the third ventricle of the brain. This cystic tumor is usually diagnosed in young and middle-aged adults
• The brain ventricles are a network of cavities within the brain tissues that produce and transport cerebrospinal fluid (CSF) within the central nervous system. The ventricles and the CSF that they hold together, act as a shock absorber for the brain protecting it from head injuries
• The cause and risk factors for Colloid Brain Cyst formation are unknown. Even though uncommon, these cysts are sometimes known to present severe complications
• Small-sized and slowly-growing Colloid Cysts of Brain may not present any signs and symptoms. However, large and rapidly-progressing cysts may cause significant symptoms due to obstruction of CSF flow in the ventricles
• This results in obstructive hydrocephalus with symptoms that vary depending on whether it is a child or adult that is affected. Obstructive hydrocephalus is associated with headaches, nausea and vomiting, dizziness, memory loss, dementia, and seizures
• The treatment of Colloid Cyst of Brain may involve ‘watchful waiting’ for asymptomatic cysts or surgery for symptomatic cases, as determined by the healthcare provider. In most cases, the prognosis is good with appropriate early treatment

Who gets Colloid Cyst of Brain? (Age and Sex Distribution)

• Colloid Brain Cysts are rare and constitute only about 0.5% to 1% of all intracranial brain tumors
• These cysts are uncommon in infants and children; they are more often noted in adults in the 20 to 50 years’ age group
• Both males and females are affected, and no gender preference is noted
• Individuals of all racial and ethnic background may be affected

What are the Risk Factors for Colloid Cyst of Brain? (Predisposing Factors)

• Currently, no risk factors have been clearly identified for Colloid Cyst of Brain

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Colloid Cyst of Brain? (Etiology)

The cause of development of Colloid Cyst of Brain is unknown.

• According to research, the cyst is a mucin-filled gelatinous material surrounded by epithelium (a type of tissue)
• The cyst is believed to be of endodermal origin that seems to develop spontaneously

What are the Signs and Symptoms of Colloid Cyst of Brain?

The signs and symptoms of Colloid Cyst of Brain can vary from one individual to another and depends on the size of the cystic tumor. In general, most small tumors are asymptomatic and no significant symptoms are observed, while large tumors are known to present symptoms. In many individuals, tumors that grow slowly and remain asymptomatic, may be diagnosed during certain radiological imaging studies of the head and neck region, which are performed for unrelated health conditions.

A vast majority of the Colloid Brain Cysts are 1 cm or greater in size and found near the foramen of Monro in the third ventricle (in over 99% of the cases). Some of the uncommon brain locations for these cysts include:

• Cerebellum
• Frontal lobe
• Pons and mesencephalon

Due to involvement of the brain ventricles, obstruction of the free flow of cerebrospinal fluid (CSF) often takes place leading to increased intracranial pressure, consequently resulting in a set of associated symptoms. In many, the initial symptoms are due to the obstruction of CSF flow and hydrocephalus. If the growth rate of the cyst is slow, then the ventricular system accommodates the progressively-growing cyst and CSF flow is not usually blocked; therefore, no symptoms or only mild symptoms are observed. In some cases, the growth may be rapid with sudden manifestation of symptoms due to CSF pressure increase.

The signs and symptoms of Colloid Cyst of Brain are related to the following factors:

• Age of the individual
• Characteristic features of the cyst on imaging studies
• Size of the cyst
• Ventricular size (the CSF containing cavities in the brain)

The signs and symptoms may be intermittent, meaning they “come and go”, and may include:

• Increased intracranial pressure due to obstruction of CSF drainage, resulting in nausea, vomiting, headaches, and seizures
• Obstruction of the CSF also leads to increased size of the head with associated complications, a condition termed as obstructive hydrocephalus
• Hydrocephalus can result in enlarged head in babies, lethargy, irritability, poor feeding, nausea and vomiting, blurring of vision, loss of balance, seizures, urinary incontinence, and growth delays, among other symptoms
• Headaches that may be persistent and increasing in intensity
• Numbness and tingling sensation
• Muscle weakness; loss of strength in the arms of legs
• Visual impairment such as blurred vision, double vision, or poor eyesight
• Fatigue and lethargy
• Lack of coordination; unsteadiness and loss of balance (vertigo)
• Dizziness and fainting
• Confusion
• Changes in one’s behavior; personality changes
• Mental impairment
• Memory loss

How is Colloid Cyst of Brain Diagnosed?

A majority of cystic brain tumors may remain undiagnosed for prolonged periods, if they are asymptomatic and generally slow-growing. The slow development of symptoms may contribute to a delayed detection and diagnosis of these cysts. They may be detected when there is a sudden worsening of symptoms prompting the healthcare provider to perform radiological studies of the brain.

Symptom assessment and imaging studies (CT or MRI scans) can help establish a diagnosis of Colloid Cyst of Brain. In general, the diagnosis may involve the following tests and examinations:

• Complete physical examination and a thorough medical history
• Assessment of the presenting signs and symptoms
• Neurological, motor skills, and cognitive assessment:
  • Checking intellectual ability, memory, mental health and function, language skills, judgment and reasoning, coordination and balance, reflexes, and sensory perceptions (space, sight, hearing, touch, etc.)
  • The healthcare provider/neurologist may use the Karnofsky Performance Scale in order to assess the neurological functioning of the individual’s central nervous system (CNS)
• Electroencephalography (EEG)
• Electromyography with nerve conductivity tests
• Imaging studies that may be performed include:
  • X-ray of head and neck
  • Computerized tomography (CT) scan of the head and neck region; CT with contrast
  • Magnetic resonance imaging (MRI) scan of the central nervous system (brain and spine); MRI with contrast agents such as gadolinium
  • Cerebral angiographic studies or MR angiography: An angiogram involves injecting dye into the bloodstream, which makes the blood vessels to appear visually on X-rays. The X-ray may show a tumor in the brain or the blood vessels leading into the tumor
  • Magnetic resonance spectroscopy: This radiological technique is used to study the chemical profile of the tumor. It is often performed with and compared to corresponding MRI scan images of the affected region
  • Positron emission tomography (PET scan): A PET scan is a nuclear medicine imaging technique that uses three-dimensional images to show how tissue and organs are functioning. It may be performed to detect any malignancy, and if there is a metastasis (spread) of the tumor to other regions
• Cerebrospinal fluid analysis, where a spinal tap or lumbar puncture procedure may be performed: This diagnostic test is used to remove a sample of cerebrospinal fluid (CSF) from the spaces in and around the brain and spinal cord. The sample is removed from the lower spinal cord using a thin needle, and it is then checked for the presence of cancer cells
• Molecular studies, if necessary

Tissue biopsy: A biopsy of the affected region (brain or spinal cord) is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy sample under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy sample under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis.

A differential diagnosis to eliminate other conditions or tumor types may be considered, before arriving at a definitive diagnosis.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Colloid Cyst of Brain?

The complications of Colloid Cyst of Brain may include the following:

• Stress and anxiety due to fear of a brain tumor
• Drop attacks: In some individuals, a sudden disruption of CSF flow may result in a temporary condition known as transient lower limb paralysis, which can cause a collapse of the body; this may result in serious fall injuries and accidents
• Brain herniation can ensue from increased intracranial pressure that is left untreated for long
• Severe intellectual disability; dementia including personality changes causing a reduced quality of life
• Severely affected physical and mental health may lead to the overall quality of life being greatly reduced
• Large undetected tumors can severely affect brain function and be disabling or even life-threatening, due to mass effect/compression of surrounding tissue
• Extremely rarely, Colloid Brain Cyst is known to cause sudden death
• Occasionally, recurrence of the tumor following its incomplete surgical removal
• Damage to the muscles, vital nerves, and blood vessels, during surgery
• Post-surgical infection at the wound site is a potential complication

How is Colloid Cyst of Brain Treated?

The treatment of Colloid Cyst of Brain may involve the following:

• In some cases of small tumors and considering their slow-growing rates, the healthcare provider may propose conservative ‘wait and watch’ measures, instead of immediately recommending surgery to remove them
• Symptomatic treatment may involve the use of antiseizure medications, painkillers, steroids (to reduce inflammation), and administration of anti-depressants
• Placement of ventriculoperitoneal (VP) shunt: It is an invasive procedure that involves the use of a medical device called a VP shunt. The device is placed in the ventricles of the brain to treat hydrocephalus, and thus helps relieve excess CSF pressure on the brain
• Surgical measures to address the cyst that are based on the severity of the condition and health status of the patient includes:
  • Craniotomy and microsurgical techniques
  • Neuroendoscopic removal of the brain cyst
  • Stereotactic aspiration and drainage of brain cyst
• Follow-up care with regular screening and check-ups are important and encouraged

How can Colloid Cyst of Brain be Prevented?

Currently, there are no known methods available to prevent the occurrence of Colloid Cyst of Brain.

What is the Prognosis of Colloid Cyst of Brain? (Outcomes/Resolutions)

• The prognosis for Colloid Cyst of Brain is good with appropriate treatment, since it is a benign cyst
• Rarely, rapidly-growing cysts presenting severe complications may be noted, which can even lead to fatalities

Additional and Relevant Useful Information for Colloid Cyst of Brain:

The following article link will help you understand other cancers and benign tumors:

http://www.dovemed.com/diseases-conditions/cancer/