Colloid cyst (resulting in death)

Case contributed by A.Prof Frank Gaillard

Presentation

Recurrent headaches. Eventually became obtunded at home.

Patient Data

Age: 20
Gender: Female
Modality: CT

Non contrast CT demonstrates marked hydrocephalus resulting from a large hyperdense lesion at the foramen of Munro. There is poor grey white matter differentiation, and complete effacement of the basal cisterns, with downward (transtentorial) herniation. 

CT angiogram

Modality: CT

At the same time as the initial CT brain a CT angiogram was performed demonstrating no opacification of the intracranial ICA and no opacification of the dural venous sinuses. Note prominent (normal) opacification of the external carotid artery branches in the scalp. 

SPECT

Modality: Nuclear medicine

RADIOPHARMACEUTICAL: 99mTc HMPAO, 827 MBq

SPECT/CT studies of the brain were performed.

The initial blood flow studies showed no perfusion into the brain.

Delayed studies show no tracer uptake into the cerebrum, brainstem or cerebellum, all highly consistent with brain death.

Case Discussion

This tragic case highlights the importance of recognising colloid cysts as a cause of sudden death in young patients. 

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Case Information

rID: 33423
Case created: 12th Jan 2015
Last edited: 21st Sep 2015
Inclusion in quiz mode: Included

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