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

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

CT

CT angiogram

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. 

Nuclear medicine

SPECT

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 recognizing colloid cysts as a cause of sudden death in young patients. 

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Case information

rID: 33423
Published: 22nd Feb 2015
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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