Abstract
Surgery in the trigone of the lateral ventricle remains a challenge for neurosurgeons.
In recurrent trigonal meningiomas (RTM), the disturbance of normal anatomic structures
and adhesion due to previous surgeries, significant oedema, and their malignant properties
heighten the difficulties associated with their surgical removal. This report presents
two patients with recurrent meningiomas with anaplastic transformation at the trigone
of the lateral ventricle who were successfully treated with contralateral posterior
interhemispheric transfalcine transprecuneus (CITT) surgeries. The primary tumours
were both completely removed through a transparietal approach in previous surgeries,
but both patients experienced hemianopsia postoperatively. The second surgeries resulted
in the complete resection of the recurrent tumours without any new-onset neurological
dysfunction. The CITT approach suits most trigonal lesions with advantages of optic
radiation preservation, reduction of retraction, improved exposure, and navigation
accuracy, and because it addresses the origin of the trigonal lesion. Although the
characteristics of RTM heighten the difficulty associated with their surgical removal,
these challenges highlight the advantages of the CITT approach. In conclusion, the
CITT approach is a safe and effective procedure for the removal of RTM.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Clinical NeuroscienceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Intraventricular atypical meningiomas.J Korean Neurosurg Soc. 2011; 49: 292-295
- Surgical approaches to the atrium of the lateral ventricle: microsurgical anatomy.Surg Neurol. 2006; 65: 436-445
- The lateral and third ventricles.Neurosurgery. 2002; 51: S207-S271
- A solution to meningiomas at the trigone of the lateral ventricle using a contralateral transfalcine approach.World Neurosurg. 2013; 80: 167-172
- Malignant progression in meningioma: documentation of a series and analysis of cytogenetic findings.J Neurosurg. 2004; 101: 210-218
- Diagnosis and treatment of atypical and anaplastic meningiomas: a review.Neurosurgery. 2005; 57 ([discussion 538–50]): 538-550
- The molecular genetics and tumor pathogenesis of meningiomas and the future directions of meningioma treatments.Neurosurg Focus. 2011; 30: E6
- Anatomic relationship of the optic radiations to the atrium of the lateral ventricle: description of a novel entry point to the trigone.Neurosurgery. 2008; 63 ([discussion 202–3]): 195-202
- Posterior interhemispheric transfalx transprecuneus approach to the atrium of the lateral ventricle: a cadaveric study.J Neurosurg. 2010; 113: 949-954
- Intraventricular meningioma with drop metastases and subgaleal metastatic nodule.J Clin Neurosci. 2004; 11: 787-791
- Intraventricular malignant meningioma with CSF-disseminated spinal metastasis: case report and literature review.J Korean Neurosurg Soc. 2009; 45: 256-259
- Anaplastic transformation of an atypical intraventricular meningioma with metastases to the liver: case report.Neurocirugia (Astur). 2009; 20: 541-549
Article info
Publication history
Published online: June 07, 2014
Accepted:
March 16,
2014
Received:
September 19,
2013
Identification
Copyright
© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.