gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Transcortical approaches to trigonal and peritrigonal lesions of the lateral ventricle – surgical considerations and outcome analysis

Meeting Abstract

  • R. Gerlach - Klinik für Neurochirurgie, HELIOS-Klinikum Erfurt
  • F. Ruiz Juretschke - Neurochirurgische Klinik, Johann-Wolfgang-Goethe-Universität Frankfurt/Main
  • G. Marquardt - Neurochirurgische Klinik, Johann-Wolfgang-Goethe-Universität Frankfurt/Main
  • E. Güresir - Neurochirurgische Klinik, Johann-Wolfgang-Goethe-Universität Frankfurt/Main
  • V. Seifert - Neurochirurgische Klinik, Johann-Wolfgang-Goethe-Universität Frankfurt/Main

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocDI.04-03

doi: 10.3205/09dgnc129, urn:nbn:de:0183-09dgnc1299

Published: May 20, 2009

© 2009 Gerlach et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Tumors of the lateral ventricle account for less than 1% of all brain tumors and the ventricular trigone (VT) is the most frequent location. Due to big size, deep location and eloquent nature of the surrounding anatomy surgery of these tumors can be challenging. We analyzed a series of 18 patients with lesions of the VT operated via two different transcortical approaches (parietal lobe and middle temporal gyrus). Surgical considerations, complications and the outcome are reported.

Methods: 18 patients (11 males) with intraventricular lesions or lesions extending only minimally into the peritrigonal parenchyma were retrospectively analyzed from a series of 57 patients with peritrigonal tumors operated between 1998 and 2008. 15 tumors were primarily ventricular lesions and 3 were paraventricular masses with invasion of the ventricle Clinical data were collected from medical charts, surgical records imaging studies and follow-up records.

Results: The 10 right- and 8 left-sided lesions were approached via a parietal (n=11, 61%) or temporal route (n=7, 39%) and completely removed using standard microsurgical techniques. Neuronavigation (BrainLAB, Heimstetten Germany) was used in 11 (61%) and ultrasound in 2 (11%) cases. Histology revealed 7 meningeomas, 3 plexus papillomas, 2 ependymomas, 1 pilocytic astrocytoma, 1 haemangiopericytoma, 2 metastasis and 2 cavernous angiomas. There were 2 cases of new postoperative visual field disturbance (one by each approach) and 1 patient with postoperative aggravated hemiparesis. The median follow-up was 27 months (1–80 months). Of the 18 patients studied 17 had no or only mild disability (mRS 0–2) after surgery and were not affected in their daily living.

Conclusions: Even large trigonal lesions can be resected with low morbidity using a tailored approach depending on the expected pathology and peritrigonal extension of the tumor.