title: Parieto-Occipital Interhemispheric Precuneal Approach to the Lesions of the Atrium: Experience with 66 patients.
abstract: OBJECTIVE
  The atrium (trigone) is the most common site for intraventricular lesions. The parieto-occipital interhemispheric precuneal approach (POIPA) is one of the particular ways to reach these lesions. The aim of this study was to draw specific attention to the surgical difficulties of these lesions and to present our experience with this operative approach.
  
  
  METHODS
  Sixty-six patients with lesions located in the atrium of the lateral ventricles underwent surgical treatment in our institution using POIPA over a 13-year period. The clinical, radiological and surgical characteristics of these patients were retrieved and reviewed retrospectively. The histological diagnosis of the cases and postoperative complications were specifically focused on in this study.
  
  
  RESULTS
  Thirty-six (54.5%) patients were male and 30 patients were female with a mean age 37.9 years (range between 8 and 74 years). The lesion was in the right atrium in 25 cases and in the left in 41 (62.1%) patients. POIPA was used in all cases to remove the lesions. The most common tumor was glioblastoma (34.8%), followed by glial tumors grade I, II and III and meningiomas. The other lesions were metastases, ganglioglioma, epidermoid cysts and arteriovenous malformations. Gross total resection of the tumors was achieved in 59 patients (89.4%) while subtotal removal was performed in 7 cases. Five (7.5%) patients died within the first month after surgery. Conclusıon: POIPA provides a safe and effective way to reach lesions located in the atrium of the lateral ventricle. Knowledge of precise anatomy associated with the meticulous surgical techniques decreases the surgical morbidity and mortality of the patients.
authors.affiliation: Gaziantep University, Medical Faculty, Department of Neurosurgery, Gaziantep, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Geyik
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Erkutlu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Alptekin
authors.forename: Inan
authors.initials: I
authors.lastname: Gezgin
authors.forename: Ayşe
authors.initials: A
authors.lastname: Mizrak
authors.forename: Serhat
authors.initials: S
authors.lastname: Pusat
authors.forename: Abdulvahap
authors.initials: A
authors.lastname: Gok
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D020547:Lateral Ventricles / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult