gms | German Medical Science

Objective: Intraventricular meningiomas account for approximately 1.5% of meningiomas. During infancy and adolescence these tumors are considerably more frequent. About 600 cases are published in the literature until now. The intraventricular meningiomas originate from the choroid plexus and extend freely into the ventricular cavity or from the choroid tela and develop partly into the ventricular cavity and partly into the nerve substance. The present study deals with meningiomas of the lateral ventricles, then with those of the third ventricle. The different approaches with special regard to microsurgical-neuroanatomical and neuropsychological preponderances are subtly examined.

Method: 25 patients were included in this study, 24 with lateral ventricle meningiomas, 1 with third ventricle meningioma. The feasibility of the different approaches was tested in the research laboratory for microsurgical neuroanatomy and later applied into the operating room. In addition to clinical outcome neuropsychological investigations and quality of life measurements were performed.

Results: 21 patients showed excellent results as regards memory; two patients demonstrated a reduced performance in memory terms. The QOL was excellent in those who had good memory performance and acceptable in one patient with memory disturbance, the other patient showed a reduced QOL that was due to multimorbidity and advanced age. Two patients died from non-tumor related disease.

Conclusions: Although there are no pathognomonic signs, CCT and MRI including fibertracking nowadays permit an earlier and more precise diagnosis. These improved imaging techniques associated with individualized and tailored approaches and a better knowledge of neurophysiological functioning make possible the rational planning of correct surgical management for each individual case with excellent clinical outcome.