Transcortical Approach to Large-Sized Lateral Ventricular Tumors

Background Intraventricular surgery is one of the most challenging procedures owing to complex anatomy of the lateral ventricle and proximity to vital structures. Different surgical corridors exist to reach the lateral ventricle including transcortical and transcallosal approach. In large-sized intraventricular tumors, transcallosal approach is usually preferred due to easy accessibility to different compartments of the lateral ventricle; however, significant morbidity can be encountered from incision to corpus callosum with limited access to lateral side of the ventricle.

Aim of the Work Assess the use of transcortical approaches (anterior or posterior) to large-sized intraventricular tumors with minimal morbidity.

Materials and Methods Twenty-five lateral ventricular tumors were operated upon in the period between 2008 and 2014 in Cairo University Hospital. Extension to third ventricle or contralateral lateral ventricle was not an exclusion criterion. Cases with small ventricular size or previous insertion of a ventriculoperitoneal shunt were not included in this series.

Results Twenty-five cases were included (14 males and 11 females). The age ranged between 3 and 29 years. Total excision was achieved in 23 cases. Four cases had temporary contralateral weakness, two cases had infection, and one case of mortality due to uncontrolled infection.

Conclusion Transcortical approach can be used safely in large-sized lateral ventricular tumors allowing adequate amount of maneuverability with good outcome.

Keywords lateral ventricle tumors; transcortical approach; foramen of Monro