title: Trigonal and peritrigonal lesions of the lateral ventricle-surgical considerations and outcome analysis of 20 patients.
abstract: The aim of this study is to review the results and clinical outcome of patients with surgically treated lesions within the trigone of the lateral ventricle. This is a retrospective case series of 20 (eight male, 12 female) patients with lesions of the trigone of the lateral ventricle operated between 1998 and 2008. All lesions were removed via the transcortical temporal and transcortical parietal route. Surgical complications and outcome were assessed using the modified Rankin Scale (mRS). There were four children and 16 adults with a mean age of 42 ± 22 years (min = 1, max = 74). Eight (40%) lesions grew within the trigone of the dominant hemisphere. In 17 cases, the lesion was purely intraventricular, and in three cases, a slight paraventricular extension was seen. The mean size was 4.5 cm of maximal diameter. Surgical removal was achieved via the transcortical parietal route in 13 cases (65%) and the transcortical temporal route in seven cases (35%). In all cases, complete resection was possible. According to the mRS, 13 patients improved, five remained the same, and two were lost to follow-up. One patient had an increased visual field deficit postoperatively and new hemiparesis and aphasia, but returned to the preoperative level within a few weeks. In one patient, an acute myocardial infarction occurred due to previous cardiac stent placement and in-stent stenosis. Even large trigonal lesions can be resected with low morbidity using a transcortical approach depending on the peritrigonal extension of the tumor.
authors.affiliation: Department of Neurosurgery, Goethe University Frankfurt/Main, Frankfurt/Main, Germany.
authors.forename: Fernando Ruiz
authors.initials: FR
authors.lastname: Juretschke
authors.forename: Erdem
authors.initials: E
authors.lastname: Güresir
authors.forename: Gerhard
authors.initials: G
authors.lastname: Marquardt
authors.forename: Joachim
authors.initials: J
authors.lastname: Berkefeld
authors.forename: Steffen
authors.initials: S
authors.lastname: Rosahl
authors.forename: Joachim
authors.initials: J
authors.lastname: Klisch
authors.forename: Andreas
authors.initials: A
authors.lastname: Raabe
authors.forename: Volker
authors.initials: V
authors.lastname: Seifert
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Gerlach
mesh_terms: D000328:Adult; D000368:Aged; D002540:Cerebral Cortex / Q000601:surgery; D002551:Cerebral Ventricle Neoplasms / Q000473:pathology / Q000601:surgery*; D002648:Child; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D020547:Lateral Ventricles / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D009460:Neurologic Examination; D019635:Neurosurgical Procedures / Q000379:methods*; D010296:Parietal Lobe / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome