title: Integrated functional neuronavigation-guided resection of small meningiomas of the atrium via the paramedian parieto-occipital approach.
abstract: OBJECTIVE
  Small meningiomas located in the atrium of the lateral ventricle remain a challenge for neurosurgeons due to the eloquent nature of the surrounding anatomy. Functional MRI (fMRI) and diffusion tensor tractography (DTT) allow for in vivo demonstrations of eloquent cortical structures and neuronal fiber tracts, respectively. Our objective is to evaluate the contribution of functional neuronavigation combined with fMRI and DTT results to surgical outcomes.
  
  
  METHODS
  we investigated 11 patients with small meningiomas located in the atrium of the lateral ventricle who underwent surgery with the aid of functional neuronavigation via the paramedian parieto-occipital approach. The patients willingly underwent assessments of neurologic deficits preoperatively and postoperatively at discharge and at three months after surgery.
  
  
  RESULTS
  Gross total resection was achieved in all patients, and no residual or recurrent tumors were observed on follow-up imaging. There was no mortality. Only one patient suffered from transient postoperative aphasia (mild to moderate) that was resolved one week after surgery. No novel neurologic deficits were present in any of the other patients, and no new-onset epileptic attacks were observed.
  
  
  CONCLUSIONS
  With the aid of the neuronavigation that incorporates fMRI and DTT results, small meningiomas located in the atrium of the lateral ventricle can be safely resected through the paramedian parieto-occipital approach.
authors.affiliation: Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Occupational and Environmental Health and The Ministry of Education Key Laboratory of Hazard Assessment and Control in Special Operational Environment, School of Public Health, The Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Shen
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing 100853, China.
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing 100853, China.
authors.forename: Jiashu
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston 02115, USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston 02115, USA.
authors.forename: Yuhui
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston 02115, USA; Department of Experimental Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China. Electronic address: tu.fmmu@gmail.com.
authors.forename: Yanyang
authors.initials: Y
authors.lastname: Tu
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing 100853, China; Department of Neurosurgery, Wulumuqi General Hospital of PLA, Wulumuqi 830000, China. Electronic address: dulla@163.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Zheng
mesh_terms: D000328:Adult; D002551:Cerebral Ventricle Neoplasms / Q000601:surgery*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D020547:Lateral Ventricles / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D038361:Neuronavigation / Q000379:methods*; D016896:Treatment Outcome
keywords: Atrium; Diffusion tensor tractography; Functional MRI; Lateral ventricle; Meningiomas; Neuronavigation