Intraventricular meninigiomas: a report of 25 cases

Abstract

In order to study the clinical characteristics of intraventricular meningiomas, we analyzed retrospectively 25 patients and reviewed the literature with regard to incidence, clinical manifestation, imaging features, preoperative diagnosis, surgical findings, and histopathological results. Intraventricular meningiomas are quite rare, but they represent an important differential diagnosis of intraventricular neoplasms. Computed tomography or magnetic resonance imaging enable a correct diagnosis of intraventricular meningiomas in most of the cases. The tumors often grow slowly to a substantial size before they become symptomatic. The operative route should be selected according to the tumor's location. Out of the 24 lateral ventricular meningiomas in our series, 20 were resected via a posterior parieto-occipital transcortical approach, two were resected via a transcallosal approach, and another two tumors, located in the frontal horn and body of the lateral ventricle, were resected via a frontal approach. A median suboccipital craniotomy was performed for the fourth ventricular meningioma. The parieto-occipital route for lateral ventricular meningiomas is a safe surgical approach, which is not necessarily associated with postoperative visual deficits. Piecemeal removal of the tumor can be safely and easily performed and special attention should be paid to the choroidal vessels intraoperatively.

Meningiomas of the lateral ventricles. A review of 10 cases

“…In our series 70% were women and in general female preponderance is reported in all series and varies from 41% to as high as 82% 2,6,23,31 . In our series the mean age was 41.6 years whereas the mean age reported for the other series varied from 20 to 60 years 2,4,10,13,23 .…”

“…Meningiomas are the second most common primary brain tumour in adults and account for 12 to 20% of all intracranial tumours, of which 2.5% are intraventricular 4,16,23,33 ; in our series intraventricular meningiomas accounted for 2,2% of intracranial meningiomas. The first intraventricular meningioma was reported in 1854 by Shaw 18,36 , who described a hard, fibrous tumour located in the ventricular trigone found at autopsy in a patient who had presented language disturbances and epilepsy.…”

“…Intraventricular meningiomas are uncommon tumours that represent about 2% of all intracranial meningiomas, which in turn account for 12 to 20% of all intracranial tumours 2,4,8,10,23,31 . In a review of 500 cases of meningioma from the Academic Department of the National Hospital, Queen Square (London), Criscuolo and Symon 6 reported 10 cases in the ventricles with a 2% incidence rate.…”

Meningiomas of the lateral ventricles: A review of 10 cases

“…Meningiomas of the lateral ventricles present mainly signs of increased intracranial pressure 2,23,24,31 . Symptoms and signs frequently include headache, disturbed mentation, motor and sensory deficits, seizures, visual deficits, and ataxia 2,14,23 . Some of the early symptoms are intermittent due to recurrent blocking of the CSF circulation 17 .…”

“…CT-scan meningiomas in the lateral ventricles are slightly hyperdense, with well-defined contours that may be smooth or irregular. In about 50% of cases, a thin ring of peritumoral hypodensity, attributable to white matter oedema, can be observed 2,23,28 . In some cases there may also be hypodense areas in the centre of the mass, which is indicative of tissue necrosis.…”