Intraventricular Meningiomas, A Rare Location for a Common Tumor: About 2 Cases

Abstract

Submit Manuscript | http://medcraveonline.com offers to the neurosurgeons the opportunity to make precisely the diagnosis, and guide their surgical approaches. Meticulous and rational planning enable complete removal of these usually benign tumors, offering permanent cure and long term survival. This paper will discuss clinical, radiological findings, and surgical management of this pathological entity, through 2 cases of IVM managed in our neurosurgery department. First caseA 17 years old female, presented with increasing intracranial pressure syndrome, severe headache, vomiting, and papillary oedema grade1. The patient was without any sensory or motor deficit. The CT and MRI shows a huge intraventricular lesion located in the occipital Horne of the right lateral ventricle ( Figure 1). The patient underwent a ventricular shunting, and the tumor was excised in a second time. The removal was complete using a temporo parietal approach, and the post operative status was stable, with improvement of the headache. The histological exam indicates a fibroblastic meningioma (Figure 2). Second caseA 15 years old girl, consulting for severe headache, with vomiting, and diplopia. The physical examination shows no motor or sensory deficit, and right 6 th nerve pulsy, with papillary oedema grade 2. CT and MRI show a very large intraventricular tumor, located at the right lateral ventricle (Figure 3 & 4). The patient underwent ventricular shunting, and the tumor was removed in a second time. The excision was total using a temporo parietal approach, and the post operative status was simple, with improvement of the headache. The histological exam indicates a fibroblastic meningioma too. AbstractIntraventricular meningiomas IVM, make up 0,5-3% of all intracranial meningiomas, and represent one of the most challenging tumors in neurosurgery. Being initially asymptomatic usually attains a large size before detection. we review through 2 cases of IVM managed in our neurosurgery department, the clinical, radiological and evolutionary features of these lesions.

Microsurgical Management of a Rare Incidental Intraventricular Meningioma: a Case Report and Relevant Literature Review

“…In contemporary diagnostics, contrast enhancement on CT/MRI scans is helpful in delineating the characteristic regular lobular shape of a tumor causing dilatation of the affected ventricle 6,9,11,20 . Histologically, IVMs are described as predominantly fibrous, fibroblastic, and psammomatous, with fibroblastic meningioma as the most common type identified in the lateral ventricles 9,11,27 .…”

“…Intraventricular meningiomas are generally benign, and total tumor surgical excision remains the primary goal of management, despite difficulties related to its location and size 5,6,9,12,16 . Therefore, neurosurgical planning should be meticulous and accurate 6 .…”

“…Postoperative brain computed axial tomography revealing complete tumor resection without any signs of cerebral regional ischemia, hemorrhage, or residual tumor. gical approaches have been described for the IVMs located at the lateral ventricle trigone area, including temporo-parietal, posterior temporo-parietal, superior parietal, posterior middle temporal, posterior interhemispheric, transcallosal, and posterior parieto-occipital approach 6,9,20,23,29 , but the optimal one still remains controversial. Different factors such as patient preoperative symptoms, physical condition and comorbidity, minimization of transcortical injury, and better access to feeding blood vessels have to be taken into consideration when deciding on the best surgical approach.…”

“…They may be found in any intracranial location including brain convexity, and the skull base [1][2][3][4][5] . Still, intraventricular meningiomas (IVMs) are rare lesions with an incidence of approximately 0.5%-3% of all intracranial meningiomas [6][7][8][9][10][11][12][13] . As with other meningiomas, a female predominance was observed in previous research, while most of IVMs were diagnosed after the third decade of life, and were less common in pediatric patients 6,[14][15][16][17] .…”

“…Still, as they enlarge in size, several symptoms including the rise of intracranial pressure (ICP), visual field defects, ataxia, and motor weakness may appear 7,[10][11][12]14,18,22 . Progressive cognitive problems and memory loss, and/or rare intraventricular hemorrhage may also be presenting signs 9,23,24 . Many symptoms may be transient, which greatly contributes to delayed diagnosis in a number of patients 6 .…”