Clinical results of the superior parieto-occipital transcortical approach for intraventricular meningiomas in the trigone of lateral ventricle: a report of 24 cases

Abstract

Introduction：Intraventricular meningiomas are uncommon subtype of intracranial meningiomas. Trigonal meningiomas consist of the majority of intraventricular meningiomas. The superior parieto-occipital transcortical approach is the most popular approach for removal of them. We analyzed our experience in removal of the trigonal meningiomas that were resected using the superior parieto-occipital transcortical approach. Patients and Methods：Twenty-four patients underwent surgical removal of trigonal meningioma from 1997 to May 2012. Demographics, clinical features, surgical outcomes, histopathologic results and prognosis were analyzed. Results：Study population had a mean age of 51.2 years and a female preponderance of 1 : 1.7. The most common presenting symptom was chronic headache, which was followed by memory impairment, visual disturbance and hemiparesis. Total removal of the tumor was achieved in all cases. Twenty-two (91.7%) tumors were World Health Organization (WHO) grade I while two cases were WHO grade III. There were two cases of intracerebral hemorrhage in the surgical corridor, one case of transient contralateral hemiparesis with cognitive decline, one case of transient contralateral homonymous hemianopsia, one case of aggravation of visual field defect, and one case of hydrocephalus which was successfully treated by ventriculo-peritoneal shunt. Conclusion：The superior parieto-occipital approach is suitable for most of the trigonal meningiomas and total removal of them can be achieved safely.