• World Neurosurg · May 2019

    The Impact of Colloid Cyst Treatment on Neurocognition.

    • Jonathan Roth, Gal Sela, Fani Andelman, Erez Nossek, Hanoch Elran, and Zvi Ram.
    • Department of Neurosurgery, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel. Electronic address: jonaroth@gmail.com.
    • World Neurosurg. 2019 May 1; 125: e372-e377.

    BackgroundColloid cysts (CC) have been associated with neurocognitive function (NCF) decline, both preoperatively and after resection. Factors such as local pressure on the fornix and hydrocephalus are thought to contribute to preoperative NCF decline. The potential cause of postoperative decline is thought to be forniceal injury during surgery. In the current series, we describe NCF outcomes amongst patients with CC, both nonoperated and operated.MethodsA total of 36 patients (23 operated, 13 nonoperated) were included in this retrospective study. All patients underwent at least 1 NCF evaluation battery. Of the 13 nonoperated cases, 5 had follow-up tests too. Of the 23 operated, 14 had both pre- and postoperative tests, and 8 had early and late postoperative tests.ResultsThere was no significant difference in baseline NCF between nonoperated and operated cases (as evaluated preoperatively). Nonoperated patients had a stable NCF test over time. Patients who were operated showed a significant improvement after surgery in several NCF variables. There was no significant change in NCF between early and late postoperative evaluation. None of the operated patients had a postoperative NCF decline.ConclusionsPatients with CC should undergo routine NCF testing with a standardized protocol, whether they are operated or followed. Surgery has a positive impact on NCF; however, it remains to be determined if the improvement is solely secondary to treatment of hydrocephalus, or to a reduction of local pressure on the fornices. It remains to be determined whether the surgical technique, that is, endoscopic, interhemispheric, or transcortical, has an impact on NCF outcome.Copyright © 2019 Elsevier Inc. All rights reserved.

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