Surgical Management of Intraventricular Meningioma; 20 Years’ Experience

Introduction: Intraventricular meningioma is a rare tumor, about only 2% of intracranial meningiomas in adults and about 10% in children. It is mostly located in trigone of the lateral ventricle with left side preponderance 60%. There are many surgical approaches for management of these tumors including: transcallosal parietooccipital, transcortical superior parietal, transcortical middle temporal, and transcortical inferior temporal approaches. Material and Method: In the period between 1991 and 2011 we operated 39 patients with intraventricular meningioma—24 females, 15 males. Age ranged from 9 to 76 years. Size ranged from 2.5 to 7 cm, 34 located in lateral ventricle, 3 in III ventricle, and 2 in IV ventricle. Most patients presented with headache followed by signs of increased ICP, visual defects, and hemiparesis. Results: Total excision 97%, no recurrence, no mortality. Karnosky score was worse postoperatively in two patients. Improvement of pre-OP symptoms occurs in 80%. In 15% of patients there was no improvement. Conclusions: Surgery is the best management when indicated. Judicious preoperative plan, adequate knowledge of anatomy, and use of correct microsurgical techniques are fundamental in achieving complete resection with low morbidity.