Challenges in Intraventricular Meningiomas Surgery, Case Presentation and Review of the Literature

Abstract

Objectives: Review on the management of meningiomas of the ventricular atrium according to what has been reported in the literature and in the experience of our institution.

Background: Intraventricular meningiomas represent 1 to 5% of meningiomas. Approaches are suggested depending on tumor location and extension, proximity to eloquent areas or pathways (motor, sensory, optic radiation, language), vascular pedicles. In this case, it is a 41-year-old female patient who presents a stabbing headache in the left parieto-temporal region with an intensity of 7/10. Clinically mental functions with impaired retrograde memory and anterograde, acalculia, preserved judgment and abstraction, bradilalia, bradypsychia, for which he went for evaluation and a cranial tomography study with contrast was carried out, evidencing intraventricular extra axial tumor lesion, for which he underwent surgical procedure through excision of a probable
left intraventricular extra axial lesion meningioma vs choroid plexus papilloma.

Methods: A bibliographic review on the surgical management of atrioventricular meningiomas and the experience at our institution was carried out.

Results: For meningiomas of the trigone, the superior transparietal or interparietal sulcus approach, with late access to the vascular pedicle and a long corridor to the lesion, provided the best option for tumor evacuation without interrupting optical radiation. Therefore, the patient presents adequate postsurgical evolution.

Conclusions: When the endoscopic intraventricular technique is not successful , the extradural subfrontal technique is recommended for direct sealing of the defect and it is important to assess IIH data during follow-up.