• 22-year-old man, student
• Increasing headache, feeling of “pressure in the head”, vomiting
• MR imaging showed a colloid cyst (arrows) with obstruction of both foramina of Monro and dilatation of both lateral ventricles.
• The cyst was removed endoscopically thought a right frontal burr hole
• At MR scan performed 3 months post operatively, there was no cyst remnant, the ventricles had decreased in size and the patient was symptom free

Equipment Used

• Storz Lotta endoscope
• 0º and 45º lenses
• Monopolar diathermy
• Endoscopic scissors
• Neuro navigation for trajectory planning

Surgical Tips

• Neuro navigation is very helpful especially if the ventricles are not very big
• The foramen of Monro may not be dilated, hence care should be taken not to damage the veins or the choroid plexus when attempting to enter it
• Often the colloid cyst, especially if it is not very big, is hidden by the choroid plexus, so you have to coagulate it in order to see the colloid cyst
• The colloid cyst wall is punctured and the contents are aspirated with suction tube. This collapses the cyst and makes manipulation easier
• The attachment of the colloid cyst to the telachoroidea of the 3rd ventricle needs to be coagulated and divided with scissors, to free the cyst. Care should be taken not to pull the cyst off and cause venous haemorrhage
• After cyst removal it is important to inspect the operative cavity with the 45º lens to ensure that there are no cyst remnants