Levi
01-04-2007, 09:47 PM
To operate or not to operate? That is the question. -- Shakespeare (oh wait, no.., I mean Braintalk, colloid cyst forum, damn memory:-)
Hi all:
First off, take all this info as my personal opinion and with a grain of salt. I am nobody! I have no medical training, etc. When writing this, my only intent is to inform. As I pondered Dave's question, my first inclination was that "conservative management" is indeed an appropriate response to a colloid cyst diagnosis. I think that I had seen this action stated several times in the literature out there about colloid cysts (1). I think that the brain surgery to remove this cyst will remain an "art form" for the foreseeable future because it is so rare (2) but that there are many good artists (aka: neurosurgeons) and centers of excellence that can do a total resection either with the microscope or with the endoscope as has been stated here in the past.
Why all colloid cysts should be removed:
o Chance of sudden death associated even with small cysts (3)
o Chance of associated behavioral changes or psychiatric disorders (4)
o Chance of wreaking havoc on one's endocrine or limbic system (personal experience)
o Chance to minimize the invasiveness of the brain surgery while the cyst is small
Best Regards,
Matthew
1) "If a patient has a small (<9 mm) colloid cyst that is not causing either symptoms or evidence of hydrocephalus on MRI, then conservative management is typically recommended (serial MRI scans)".
http://neurosurgery.ucla.edu/Programs/BrainTumor/BrainTumor_Colloid%20cyst.html
(http://neurosurgery.ucla.edu/Programs/BrainTumor/BrainTumor_Colloid%20cyst.html)
2) "Approximately three persons per million per year are affected by this entity"
http://www.wjso.com/content/pdf/1477-7819-4-47.pdf
(http://www.wjso.com/content/pdf/1477-7819-4-47.pdf)
3) "However, since even small colloid cysts have been associated with sudden death, the precise criteria that differentiate cysts that require surgery from those that do not are uncertain at this time."
http://www.ajnr.org/cgi/reprint/19/5/875.pdf
(http://www.ajnr.org/cgi/reprint/19/5/875.pdf)
"Cyst size can range from 3–40 mm but size may not be a reliable predictor of outcome as even small cysts may cause sudden death"
http://www.wjso.com/content/pdf/1477-7819-4-47.pdf
(http://www.wjso.com/content/pdf/1477-7819-4-47.pdf)
“Cyst size does not appear to be a reliable predicator of outcome, since small cysts may result in sudden death.”
http://findarticles.com/p/articles/mi_qa3958/is_200309/ai_n9285362
(http://findarticles.com/p/articles/mi_qa3958/is_200309/ai_n9285362)
4) “Other symptoms may include decreasing memory, behavioral changes, and dizziness.”
http://neurosurgery.ucla.edu/Programs/BrainTumor/BrainTumor_Colloid%20cyst.html
(http://neurosurgery.ucla.edu/Programs/BrainTumor/BrainTumor_Colloid%20cyst.html)
Hi all:
First off, take all this info as my personal opinion and with a grain of salt. I am nobody! I have no medical training, etc. When writing this, my only intent is to inform. As I pondered Dave's question, my first inclination was that "conservative management" is indeed an appropriate response to a colloid cyst diagnosis. I think that I had seen this action stated several times in the literature out there about colloid cysts (1). I think that the brain surgery to remove this cyst will remain an "art form" for the foreseeable future because it is so rare (2) but that there are many good artists (aka: neurosurgeons) and centers of excellence that can do a total resection either with the microscope or with the endoscope as has been stated here in the past.
Why all colloid cysts should be removed:
o Chance of sudden death associated even with small cysts (3)
o Chance of associated behavioral changes or psychiatric disorders (4)
o Chance of wreaking havoc on one's endocrine or limbic system (personal experience)
o Chance to minimize the invasiveness of the brain surgery while the cyst is small
Best Regards,
Matthew
1) "If a patient has a small (<9 mm) colloid cyst that is not causing either symptoms or evidence of hydrocephalus on MRI, then conservative management is typically recommended (serial MRI scans)".
http://neurosurgery.ucla.edu/Programs/BrainTumor/BrainTumor_Colloid%20cyst.html
(http://neurosurgery.ucla.edu/Programs/BrainTumor/BrainTumor_Colloid%20cyst.html)
2) "Approximately three persons per million per year are affected by this entity"
http://www.wjso.com/content/pdf/1477-7819-4-47.pdf
(http://www.wjso.com/content/pdf/1477-7819-4-47.pdf)
3) "However, since even small colloid cysts have been associated with sudden death, the precise criteria that differentiate cysts that require surgery from those that do not are uncertain at this time."
http://www.ajnr.org/cgi/reprint/19/5/875.pdf
(http://www.ajnr.org/cgi/reprint/19/5/875.pdf)
"Cyst size can range from 3–40 mm but size may not be a reliable predictor of outcome as even small cysts may cause sudden death"
http://www.wjso.com/content/pdf/1477-7819-4-47.pdf
(http://www.wjso.com/content/pdf/1477-7819-4-47.pdf)
“Cyst size does not appear to be a reliable predicator of outcome, since small cysts may result in sudden death.”
http://findarticles.com/p/articles/mi_qa3958/is_200309/ai_n9285362
(http://findarticles.com/p/articles/mi_qa3958/is_200309/ai_n9285362)
4) “Other symptoms may include decreasing memory, behavioral changes, and dizziness.”
http://neurosurgery.ucla.edu/Programs/BrainTumor/BrainTumor_Colloid%20cyst.html
(http://neurosurgery.ucla.edu/Programs/BrainTumor/BrainTumor_Colloid%20cyst.html)