Colloidal cyst of the III ventricle
Colloidal cyst of the III ventricle – a new growth of rounded shape which settles down in a cavity of the III ventricle of a brain. Is not a cancer tumor, does not spread, but it is capable to growth. Danger to the patient consists in overlapping of ways of circulation of a likvor with development of a gidrotsefalny syndrome. At the small sizes proves nothing. With a progressive growth it is characterized by sudden attacks of headaches with vomiting, noise in ears, sight violation, memory easing. It is diagnosed on pictures of KT and MPT. Treatment mainly quick – removal of all cyst and restoration of current of tserebrospinalny liquid.
Colloidal cyst of the III ventricle
The colloidal cyst of the III ventricle is a good-quality new growth which settles down in the front and top part III of a ventricle of a brain. It has spherical shape, is surrounded with the dense capsule from connecting fabric, contents are presented by the jellylike mass of green-gray color which is a product of secretion of cages of a wall of a cyst. The sizes of a new growth depend on duration of a course of pathological process, in certain cases the cyst can occupy practically all cavity of a ventricle of a brain.
Pathology does not belong to the category of malignant tumors, that is does not give metastasises, however the new growth is capable to the progressive growth in this connection poses hazard to life of the patient. This kind of cysts meets quite seldom and makes about 1% of all tumors of a brain. Colloidal cysts of a brain can be found in patients at any age, and also with an identical frequency occur at men and women.
The causes of colloidal cysts of the III ventricle are still unknown to medicine. Some researchers assume that their education is result of violation of development of nervous system in the pre-natal period. The human embryo until formation of cerebral hemispheres has a special outgrowth (rudiment) of nervous tissue which resolves during individual development and by the time of the birth at a fruit is absent. Process of normal growth of a brain is broken at negative impact of various external factors during pregnancy: ecology, addictions, stresses; development of heavy toxicosis; developing of a pre-natal infection or a Rhesus factor conflict on early terms of pregnancy. The site of germinal fabric remains, its cages begin to produce jellylike liquid which is delimited by a dense soyedinitelnotkanny cover – the colloidal cyst of the III ventricle is so formed.
Originally the size of a new growth does not exceed several millimeters. At influence of provocative factors the colloidal cyst of the III ventricle begins to increase promptly. What is the true reason of growth of a cyst it is not found out yet. There are assumptions that it is promoted by stresses, a sleep debt, obesity, addictions.
The brain is not the continuous mass of nervous cages, in his cavity several emptiness which are called ventricles settle down. In them the likvor – tserebrospinalny liquid circulates. There are 4 ventricles of a brain: I and II (they are called side), III, IV. All of them make ways of circulation of a likvor and are connected among themselves by openings. Tserebrospinalny liquid is produced by special congestions of the thinnest blood vessels located on walls of ventricles of a brain. At the healthy person the likvor freely flows from one ventricle in another. With a growth of a colloidal cyst there is a closing of channels of its circulation, and it cannot get from the III ventricle to IV. There is a congestion of liquid and increase in intra cranial pressure.
If growth of cystous education goes not towards connection of channels, then increase in intra cranial pressure happens gradually, and symptoms of a disease prove for a long time (up to 10 years). With a bystry growth of a new growth in the field of anatomic openings of circulation of a likvor or at sudden shift of a cyst symptoms of sharp obstruction of likvorny ways develop.
Feature of an arrangement of a colloidal cyst in a cavity of the III ventricle leads to the fact that at increase in the sizes of the last there is pressure upon the arch of a brain and a kernel of a hypothalamus, it leads to violation of process of storing of recent events (short-term memory), violation of regulation of body temperature, the mode of a dream and wakefulness, full loss of feeling of hunger (anorexia) or, on the contrary, saturation (bulimia), to change of the emotional sphere.
The colloidal cyst of the III ventricle in itself does not represent health hazard of the patient. Clinical manifestations depend only on its sizes. The fact that the small cysts which are available for the person since the birth do not affect the state of health is explained by it. Danger of new growths consists in their progressive growth.
All clinical manifestations of pathological process can be divided into 3 groups: symptoms of sharp obstruction of ways of circulation of tserebrospinalny liquid; symptoms of gradual increase of intra cranial pressure – a gidrotsefalny syndrome; violations of the highest brain functions – short-term memory, mental capacities, and also development of frustration of a metabolism.
Symptoms of sharp obstruction of likvorny ways are presented by sharp increase in intra cranial pressure. It is characterized by sharply arisen intolerable headache, noise in ears, consciousness loss, spasms, in certain cases the patient can fell into a coma.
The following symptoms are characteristic of gradual increase in intra cranial pressure: headache, vomiting, violation of sight, spasm.
The headache at a gidrotsefalny syndrome has the following features: amplifies in a prone position, after a dream by the morning, does not act the popular anesthetizing medicines, is followed by nausea, vomiting, and also is more rare consciousness oppression (drowsiness).
Vomiting with the increased intra cranial pressure, as a rule, has uncontrollable character, does not give relief that distinguishes it from vomiting, for example, at food poisoning; often arises at headache attack height.
Hypostasis of disks of an optic nerve develops as result of pressure of the likvor which accumulated in subweb space. It leads to sight violation: the patient complains of shadows (front sights) before eyes, flashing of flashes of light. Visual acuity at the initial stages of a disease is not changed, but if increase in intra cranial pressure has chronic character, then the gradual atrophy of an optic nerve which is shown the progressing falling of visual acuity up to a blindness develops.
Spasms can be as generalized when shakes all body of the patient, and partial when twitchings are observed in separate muscles, for example, the isolated spasms of a hand or a leg. Long increase in intra cranial pressure makes negative impact on cortical substance of a brain that leads to violation of the highest brain functions: to decrease in intelligence, loss of short-term memory.
Frequent displays of a colloidal cyst of the III ventricle are okklyuzionny crises – short-term obstruction of likvorny ways. It can be observed at the sudden shift of a body of a cyst in a cavity of a ventricle of a brain and blocking of outflow of tserebrospinalny liquid. Through short time normal circulation is restored, and symptoms disappear. Okklyuzionny crises are characterized by the sudden sharp headache which is followed by face reddening, heartbeat, breath increase, heat or, on the contrary, a fever, arrhythmic pulse, jumps of arterial pressure. All this can occur against the background of suddenly arisen weakness and loss of a muscular tone in a hand or a leg.
At suspicion of a colloidal cyst of a brain the neurologist has to direct the patient to the following inspections: Brain MRT with contrast, brain KT, consultation of the ophthalmologist. Usually these methods happen enough to establish the correct diagnosis.
In pictures of a computer tomography the colloidal cyst looks round formation of whitish color which settles down in a cavity of the III ventricle of the brain having black color on the roentgenogram. Cyst fabric coloring much more intensively than the next tissue of a brain which has a grayish shade in pictures.
Consultation of the oculist is necessary for carrying out an oftalmoskopiya for the purpose of assessment of a condition of an eye bottom – whether hypostasis of disks of an optic nerve, and definition of a condition of a retina takes place. During diagnostics the colloidal cyst of the III ventricle needs to be otdifferentsirovat from adenoma of a hypophysis, a germinoma, a kraniofaringioma, a glioma of a hiazma, a tumor of a shishkovidny body and metastatic processes of this localization.
In offices of neurology at treatment of colloidal cysts of the III ventricle doctors adhere to the following tactics: formations of the small sizes without existence of symptoms of a disease are not treated, direct the patient to an annual picture of MPT or KT on which estimate the amount of education and his tendency to growth. At new growths of the big sizes with clinical manifestations or at the progressing increase in a cyst consultation of the neurosurgeon for the solution of a question of surgical treatment is shown.
Main goals of surgery are: full removal of a cyst, release of likvorny ways and elimination by that of a syndrome of the increased intra cranial pressure. The following surgical techniques are applied: kraniotomiya and endoscopic removal. Kraniotomiya – opening of a cranium and an open brain operation, she allows to remove completely a new growth, to examine a cavity of the III ventricle, to restore likvorny ways. Its shortcomings are big injury and cosmetic defect after operation. Endoscopic removal of a colloidal cyst is carried out through a small opening in skull bones by means of the special device which allows both to examine a cavity of the III ventricle, and to remove a new growth.
Forecast and prevention
The forecast of a disease at the small amount of the cystous education not inclined to growth, favorable. It does not affect health of the patient in any way. At the uncured growing cyst the forecast adverse. Hydrocephaly which can become a cause of death of the patient owing to violation of work of heart and breath at cave-in of a brain in natural anatomic openings of a skull and jamming in them the vital centers develops. Memory violation, development of the acquired weak-mindedness are characteristic. The coma and the death of the patient at sharp obstruction of likvorny ways are possible.
After operation on removal of cystous education and restoration of current of tserebrospinalny liquid modern methods note almost absolute recovery of patients. In rare instances there is a retsidivirovaniye of pathological process, then there is a need of repeated operation.
As the colloidal cyst of the III ventricle presumably arises as result of violation of pre-natal development, for prevention of its emergence it is necessary to avoid during pregnancy self-treatment by any medicines, to refuse addictions, to observe the dream mode, to use multivitamin complexes. For prevention of the beginning of growth of a colloidal cyst at adults it is necessary to lead a healthy lifestyle.