A Fifteen Year-Old Female Presenting with a Two-Month History of Intermittent Headaches, Especially Worse in the Morning
Phillip Correia Copley*
Brighton & Sussex Medical School, UK *
Colloid cysts account for less than one percent of all intracranial tumors. They are non-neoplastic cysts walled by epithelial, mucin-producing, ciliated cells that secrete a thick gelatinous substance into the cyst. They most commonly originate in the roof of the anterior third ventricle just posterior to the foramen of Monro. This proximity to the foramen can lead to obstructive hydrocephalus and subsequent increased intracranial pressure, which results in headaches and drop attacks. Other symptoms may include vertigo, memory deficits, diplopia and changes in behavior. Cases of sudden death have been also described in the literature.

This case describes a fifteen year-old female that presented with a two-month history of intermittent headaches, especially worse in the morning, with associated nausea and vomiting. Diagnosis of a colloid cyst was made on computed tomography imaging in the emergency department. Initial emergency management was via placement of an external ventricular drain to monitor intracranial pressure and prevent the potential complication of sudden death. Within 48 hours definitive management was performed via trans-cortical resection of the cyst, with excellent long-term prognosis.

Although rare, this case demonstrates the importance of colloid cysts as a differential diagnosis for children presenting with headache.
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