Microsurgical management of lateral ventricular meningiomas: a report of 51 cases.

BACKGROUND: Lateral ventricular meningiomas are notably rare and the optimal surgical management for them remains a challenge. We made a retrospective study of patients with these lesions and analyzed the clinical findings, radiological features and especially the surgical treatment on the basis of surgical approaches and techniques.
MATERIALS AND METHODS: A total of 51 patients with lateral ventricular meningiomas were operated on between 1996 and 2006 in our institution. The mean patient age was 44 years (range: 14-75 years). The most common presenting symptoms were related to the gradually increasing high cranial pressure (82.4%) rather than the location of the tumor. The transcortical parieto-occipital approach was used in 38 patients, the temporal approach was used in 9 patients and the transcallosal approach was used in 4 patients.
RESULTS: The total surgical excision was complete in 48 patients (94.1%), and 3 patients with subtotal excision received radiotherapy after the operation. The previous visual fields deficits in two patients worsened and a new visual disturbance or sensory aphasia appeared in two patients. One patient died of postoperative hypothalamus complications. Thirty-eight patients underwent follow-up (range: 6 months-10 years). The conditions of 35 of these were excellent or good. No recurrence has been seen in any patient.
CONCLUSIONS: Understanding the features of lateral ventricular meningiomas will help one to select an appropriate surgical approach. An individualized approach is needed, and the transcortical parieto-occipital approach or transtemporal approach is advantageous for most cases in our opinion. Also, it is possible to achieve a good surgical outcome with little neurological morbidity if we take wise strategies and techniques during excision.