RUDN University doctors named risk factors for death due to a cyst in the brain

The third ventricle of the brain is a cavity between the optic thalamus filled with cerebrospinal fluid. Sometimes a colloid cyst forms in it. This is a benign formation, but it can block the foramen of Monroe, through which the third ventricle communicates with other cavities of the brain. This leads to hydrocephalus, an excess accumulation of cerebrospinal fluid. In extreme cases, acute deterioration may occur, leading to sudden death. Very little is known about such outcomes, but it is important to learn how to avoid them. RUDN University doctors analyzed data on all described fatal cases associated with a colloid cyst of the third ventricle.

“Colloid cysts are benign tumors that are found almost exclusively in the third ventricle. It can cause hydrocephalus and, less commonly, acute deterioration and even sudden death. Since very few cases of sudden death have been described in the literature, not much is known about the patients and the characteristics of the cyst in these patients,” Musa Gerald, assistant at the Department of Neurology and Neurosurgery with a course of comprehensive rehabilitation at RUDN University.

Doctors were able to find 65 described cases in which the death of the patient occurred with a diagnosed colloid cyst. The authors analyzed the collected data using statistical methods. To find possible relationships, RUDN doctors paid attention to all previous syndromes, cyst size, hemorrhage into the cyst, and demographic indicators.

Of the 65 patients, there were 38 men and 27 women. The average age was 27.4 and 28.5, respectively. There were no statistically significant differences between men and women for any of the clinical indicators. Most patients have a history of sudden and severe headaches accompanied by nausea. Almost all (97%) were diagnosed with ventriculomegaly, an abnormal increase in the volume of the ventricles of the brain, on radiological studies. Sudden death in most cases was preceded by hemorrhage into the cyst. The size of the cyst also likely plays a role—all of the patients who died had cysts larger than 1 cm in diameter.

“Sudden death in colloid cysts is a rare event, the pathophysiology and risk factors of which still need to be studied. All patients with acute headaches accompanied by nausea or vomiting should be carefully evaluated to rule out colloid cysts and other life-threatening conditions. Sudden deterioration and possible death should be discussed with all patients with cysts of all sizes. For colloid cysts larger than one centimeter, surgical treatment should be recommended regardless of the presence or absence of symptoms,” Musa Gerald.

The results were published in the Journal of Clinical Neuroscience.