Intraventricular Meningiomas: A Series of 42 Patients at a Single Institution and Literature Review.
BACKGROUND
Primary intraventricular meningiomas (IVMs) make up 0.5%-5% of all intracranial meningiomas and represent one of the most challenging lesions in neurosurgery.


METHODS
Between 1990 and 2013, 42 patients (30 female, 12 male; mean age, 43.6 years) underwent resection of their IVM. The removal was performed by a posterior parietal approach in 19 of the 40 lateral ventricle tumors, and 1 third ventricle meningioma. The transcallosal approach was used for 3 meningiomas, and patients with other lesions underwent temporal (7 cases) and temporoparietal approaches (12 patients), respectively.


RESULTS
The most common presenting signs were increased intracranial pressure (83.3%), visual impairment (78.6%) and cognitive changes (50%). Forty lesions (95.2%) arose in the lateral ventricles, and 2 (4.8%) in the third ventricle, ranging in size from 3 to 10 cm. Total removal was achieved in 39 cases and the pathology report disclosed World Health Organization grade I lesions in 41 cases. Hydrocephalus, cerebrospinal fluid leakage, and cerebral edema were the postoperative complications (7.15%); 1 patient died of respiratory problems not directly related to surgery. Thirty-five patients (83.3%) showed a 6-month Glasgow Outcome Scale of 5. One patient, who underwent partial resection, presented a recurrence after 1 year that remained stable until last follow-up.


CONCLUSIONS
IVMs usually reach a large size before being diagnosed. Surgical treatment is the most suitable option and total removal should represent the main goal of the procedure. The posterior parietal transulcal approach and the temporoparietal approach are the most common surgical routes used in our series.
Clinical Center of Serbia, Clinic of Neurosurgery, Medical Faculty University of Belgrade, Belgrade, Serbia.
Danica
D
Grujicic
Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
Luigi Maria
LM
Cavallo
Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy. Electronic address: teresa.somma85@gmail.com.
Teresa
T
Somma
Clinical Center of Serbia, Clinic of Neurosurgery, Belgrade, Serbia.
Rosanda
R
Illic
Clinical Center of Serbia, Clinic of Neurosurgery, Medical Faculty University of Belgrade, Belgrade, Serbia.
Mihailo
M
Milicevic
Clinical Center of Serbia, Department of Pathological Anatomy, Belgrade, Serbia.
Savo
S
Raicevic
Clinical Center of Serbia, Department of Pathological Anatomy, Medical Faculty University of Belgrade, Belgrade, Serbia.
Milica Skender
MS
Gazibara
Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
Alessandro
A
Villa
Clinical Center of Serbia, Clinic of Neurosurgery, Medical Faculty University of Belgrade, Belgrade, Serbia.
Dragan
D
Savic
Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
Domenico
D
Solari
Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
Paolo
P
Cappabianca
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008579:Meningioma / Q000134:cerebrospinal fluid* / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
Intraventricular; Lateral ventricle; Meningioma; Surgical complications; Surgical mortality; Survival; Third ventricle