gms | German Medical Science

Objective: Meningiomas of the lateral ventricle are very rare lesions accounting for a mere 1% of all intracranial meningiomas. We retrospectively reviewed a series of patients harboring a meningioma of the lateral ventricle and who underwent microsurgical resection analyzing approach-related postoperative neurological deficits.

Methods: Clinical, radiological, surgical and follow-up data were retrospectively analyzed in a consecutive series of 24 patients who underwent microsurgical resection for a meningioma of the lateral ventricle between June 1995 and June 2010.

Results: The main presenting symptoms in the 24 patients (15 women and 9 men, mean age 53 yrs) was headache in 14 (58%) and gait unsteadiness in 6 (25%) patients. Preoperative clinical examination revealed a homonymous hemianopia in 6 (25%) patients and neuroimaging demonstrated hydrocephalus in (29%) cases. The meningioma was resected via a temporo-parietal approach in all but one patient who was operated via the anterior transcallosal avenue for a meningioma situated in the frontal horn. A Simpson grade 1 removal of the tumor was achieved in all patients. After surgery, 9 patients (38%) experienced a permanent new neurological deficit consisting mainly of a homonymous hemianopia / quadrantanopia in 7 patients and epileptic fits in 3 cases. Two patients died after surgery and one patient was lost to follow-up. After a mean follow-up period of 78 months with clinical examination and magnetic resonant imaging a recurrent meningioma occurred in two patients and was operated in one and treated by gamma knife radiosurgery in the other.

Conclusions: Although the temporo-parietal surgical route is a straight forward approach to meningiomas located in the trigonum of the lateral ventricle it is associated with a high incidence of new and permanent postoperative visual field deficits.