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
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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.
