Giant colloid cyst of the brain masquerading as vasovagal syncope

Vasovagal syncope is very common in the general population.1 Studies estimate that by 60 years of age, 42% of women and 32% of men will have had at least 1 vasovagal episode.2 A careful review of the patient’s history and witness account are essential in the diagnosis, as is eliciting the predisposing factors. Vasovagal syncope generally is considered benign, resulting from an exaggerated neurocardiogenic reflex, but rarely it may be associated with pathologic conditions. Colloid cysts are rare congenital neoplasms commonly located in the third ventricle.3 Syncope associated with colloid cysts is extremely rare, although sudden death has been reported.3 We report a case, confirmed with tilt table testing, of vasovagal syncope in the setting of a large colloid cyst in the third ventricle. After successful resection of the colloid cyst, the patient’s symptoms resolved completely and tilt table testing became negative.