Dear Dr Joshua,

Need some clarity re this MRI brain Scan..

MRI Brain Scan showing features of colloid cyst(+-1cm diam) between foramina of Munro, with mild to moderate dilatation of lateral ventricles causing degree of hydrocephalus also revealing extensive mucosal thichening of all oaranasal sinuses, especially ethmoid and frontal sinuses..what would have caused the cyst and the hydrocheph..what does this indicate and what would be the likely treatment?
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Dr. Joshua’s answer:

Colloid cyst is a benign tumor, also known as neuroepithelial cyst. We don’t know what causes it. They often occur at the foramina of Monro, which is an important spot for proper flow of the cerebrospinal fluid (CSF).

In your case, the cyst is partially blocking the flow of the fluid, causing hydrocephalus and increased pressure inside the head (hydrocephalus).

Treatment options are in this case either bilateral shunting or surgical removal. The treatment of choice depends on what’s available in your area. If you have no access to a skilled neurosurgeon with a good track record of removing colloid cysts microsurgically, then simple shunting may be the treatment of choice due to lower risks involved. If however you do have access to such a skilled neurosurgeon, then surgical removal is probably the better option.

Shunting is an option because the cyst itself is so slow growing that it is unlikely to cause any problems due to its own mass effect. The problem arises from the CSF blockage, and shunting would take care of that, but is not without problems (shunts get infected, they get clogged, many need reoperations etc). Surgical removal is best because it will result in a complete cure and you will require no shunting. More and more neurosurgeons are adapting what we call the ‘transcallosal’ approach to surgical removal, which, in good hands, results in cure and has a reasonably low risk of complications, and recovery is fast. However, the transcallosal approach is demanding and high-risk, if the neurosurgeon is not skilled in that particular operation. The possible complications include memory problems.

You must be treated because you already have developed hydrocephalus. Failure to treat would be dangerous and could lead to severe problems or even death.

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Tags: brain, brain mri, Brain Tumor, colloid cyst

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