Advertisement

To repeat or to recreate: A contralateral posterior interhemispheric transfalcine transprecuneus approach for recurrent meningiomas at the trigone of the lateral ventricle

  • Author Footnotes
    1 These authors have contributed equally to the manuscript.
    Chongjing Sun
    Footnotes
    1 These authors have contributed equally to the manuscript.
    Affiliations
    Department of Neurosurgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China
    Search for articles by this author
  • Author Footnotes
    1 These authors have contributed equally to the manuscript.
    Tao Xie
    Footnotes
    1 These authors have contributed equally to the manuscript.
    Affiliations
    Department of Neurosurgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China
    Search for articles by this author
  • Xiaobiao Zhang
    Correspondence
    Corresponding author. Tel.: +86 133 8605 6983; fax: +86 021 6404 1990.
    Affiliations
    Department of Neurosurgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China

    Shanghai Key Lab of Medical Image Computing and Computer Assisted Intervention, Shanghai, China
    Search for articles by this author
  • Wei Zhu
    Affiliations
    Department of Neurosurgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China
    Search for articles by this author
  • Ye Gu
    Affiliations
    Department of Neurosurgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China
    Search for articles by this author
  • Hongzhang Wang
    Affiliations
    Department of Neurosurgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China
    Search for articles by this author
  • Author Footnotes
    1 These authors have contributed equally to the manuscript.

      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 access
      One-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 Neuroscience
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kim H.D.
        • Choi C.Y.
        • Lee D.J.
        • et al.
        Intraventricular atypical meningiomas.
        J Korean Neurosurg Soc. 2011; 49: 292-295
        • Kawashima M.
        • Li X.
        • Rhoton A.L.
        • et al.
        Surgical approaches to the atrium of the lateral ventricle: microsurgical anatomy.
        Surg Neurol. 2006; 65: 436-445
        • Rhoton Jr, A.L.
        The lateral and third ventricles.
        Neurosurgery. 2002; 51: S207-S271
        • Zhu W.
        • Xie T.
        • Zhang X.
        • et al.
        A solution to meningiomas at the trigone of the lateral ventricle using a contralateral transfalcine approach.
        World Neurosurg. 2013; 80: 167-172
        • Al-Mefty O.
        • Kadri P.A.
        • Pravdenkova S.
        • et al.
        Malignant progression in meningioma: documentation of a series and analysis of cytogenetic findings.
        J Neurosurg. 2004; 101: 210-218
        • Modha A.
        • Gutin P.H.
        Diagnosis and treatment of atypical and anaplastic meningiomas: a review.
        Neurosurgery. 2005; 57 ([discussion 538–50]): 538-550
        • Choy W.
        • Kim W.
        • Nagasawa D.
        • et al.
        The molecular genetics and tumor pathogenesis of meningiomas and the future directions of meningioma treatments.
        Neurosurg Focus. 2011; 30: E6
        • Mahaney K.B.
        • Abdulrauf S.I.
        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
        • Wang S.
        • Salma A.
        • Ammirati M.
        Posterior interhemispheric transfalx transprecuneus approach to the atrium of the lateral ventricle: a cadaveric study.
        J Neurosurg. 2010; 113: 949-954
        • Darwish B.
        • Munro I.
        • Boet R.
        • et al.
        Intraventricular meningioma with drop metastases and subgaleal metastatic nodule.
        J Clin Neurosci. 2004; 11: 787-791
        • Eom K.S.
        • Kim H.S.
        • Kim T.Y.
        • et al.
        Intraventricular malignant meningioma with CSF-disseminated spinal metastasis: case report and literature review.
        J Korean Neurosurg Soc. 2009; 45: 256-259
        • Garcia-Conde M.
        • Roldan-Delgado H.
        • Martel-Barth-Hansen D.
        • et al.
        Anaplastic transformation of an atypical intraventricular meningioma with metastases to the liver: case report.
        Neurocirugia (Astur). 2009; 20: 541-549