Surgical approaches to meningiomas of the lateral ventricles.
BACKGROUND
Intraventricular meningiomas account for 0.5-3% of all intracranial meningiomas. The majority occur in the atrium of the lateral ventricle. Surgical experience with intraventricular meningiomas is rare in the literature, and several surgical approaches exist.


METHODS
Between 1987 and 2007, 13 patients underwent resection of intraventricular meningiomas. All patients had tumors of the lateral ventricles. These patients were retrospectively identified and their records reviewed.


RESULTS
Eleven tumors were found in the atrium, one in the frontal horn, and one in the body of the lateral ventricle. In 9 of 13 cases, the tumor occurred in the left lateral ventricle. Patients commonly presented with headache and cognitive difficulties. A visual field deficit was noted preoperatively in one patient. Four patients underwent preoperative angiography, but no patients underwent embolization. Gross total resection was achieved in all cases: 6 via a middle temporal gyrus approach, 5 via a superior parietal lobule approach, and 2 via a transcallosal approach. Image-guided stereotaxis was used in 6 cases. Pathology was benign in 12 of 13 cases; atypical features were identified in one case. There was no operative mortality, and no patients showed evidence of recurrence. Postoperatively, 3 patients developed new cognitive-linguistic deficits that subsequently resolved. One of these patients developed a new visual field deficit after surgery.


CONCLUSIONS
Several approaches are available for the surgical treatment of intraventricular meningiomas. Tumor location, extension, and laterality drive the selection algorithm for these approaches. Preoperative angiography is rarely useful, and surgical cure is the rule.
Nayar
Vikram V
VV
Department of Neurosurgery, Baylor College of Medicine, 1709 Dryden Rd, Suite 750, Houston, TX 77030, United States. vnayar@bcm.edu
DeMonte
Franco
F
Yoshor
Daniel
D
Blacklock
J Bob
JB
Sawaya
Raymond
R
D000293:Adolescent; D000328:Adult; D001037:Aphasia / Q000453:epidemiology / Q000209:etiology; D002533:Cerebral Angiography / Q000379:methods; D002551:Cerebral Ventricle Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D020547:Lateral Ventricles / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008579:Meningioma / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010468:Perceptual Disorders / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications; D011300:Preoperative Care; D020127:Recovery of Function; D013238:Stereotaxic Techniques; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D055815:Young Adult