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Presentation
Case Findings: A 56-year-old male presents with multiple episodes of syncope. One episode occurred while driving his motorcycle, causing him to sustain multiple nonsurgical cervical spine fractures. An MRI of the brain was obtained.
What is your diagnosis?
45% Giant cell astrocytoma
72% Colloid cyst
73% Oligodendroglioma
61% Ependymoma
112% Arachnoid cyst
This MRI revealed a colloid cyst, a relatively rare and benign intracranial lesion that most often occurs in the third ventricle. If the cyst grows large enough, it may block the movement of the cerebrospinal fluid in the brain, resulting in hydrocephalus. Colloid cysts contain a gelatinous fluid called colloid. The cause of cysts in the brain remains unknown.
What To Look For:
Patients with colloid cysts often present with a history of headache; other symptoms may include memory loss, vertigo, gait abnormalities, drop attacks, and behavioral changes. However, some patients are asymptomatic. Colloid cysts most often occur in adults.
Treatment:
In most cases, surgical removal of a colloid cyst is recommended. However, the location of a colloid cyst can make removal challenging.
Case Follow-Up:
The patient underwent an EEG, stress test, and echocardiogram, all of which were inconclusive. He was implanted with a loop recorder before discharge from the hospital, with instructions for follow-up with cardiology. The patient also was evaluated by neurosurgery. He received instructions for follow-up, but no immediate intervention.