Intraventricular Meningiomas – a Retrospective Study on 19 Surgical Cases

Czech version

Authors: M. Dedeciusová; D. Netuka; V. Beneš
Authors‘ workplace: Neurochirurgická a neuroonkologická klinika 1. LF UK a VFN v Praze
Published in: Cesk Slov Neurol N 2017; 80/113(5): 591-596
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2017591

Overview

Aim:
Intraventricular meningiomas are rare tumors which were not covered sufficiently in the Czech literature. Presenting our retrospective study, the aim of this article is to introduce typical clinical presentation, diagnostics, surgical treatment and its complications to the reader. Moreover, it provides a basic review of already published literature as well as it compares the achieved results with recently published series of international authors.

Material and methods:
Data of 19 patients who underwent surgery for intraventricular meningioma at our institution between 2002– 2015 were analyzed retrospectively, the average follow-up is 3 years and 5 months. The average age in our cohort was 49 years. Women were affected 2.8 times more often. The medical files, clinicoradiological findings, surgical interventions and their outcome were analyzed retrospectively.

Results:
The most common presenting symptom was headache (53%). Most frequently (89%), meningiomas were located in the lateral ventricles. Usually, the surgery were performed using parietooccipital approach, radical resection was achieved in all patients. Resolution of the previous symptoms and signs was achieved in 84% of patients. As for the permanent complications, the most often was epileptic seizure (11%), homonymous hemianopia (5%), and expressive phatic disorder (5%). There was one recurrence in our serie (5%). Concerning the high potential surgical risk, the recurrence was irradiated with the Leksell gamma knife.

Conclusion:
The gold standard of the therapy of symptomatic intraventricular meningiomas is the microsurgical resection. In the case of reccurence, stereotactic radiosurgery is as well an option. The asymptomatic tumors could be observed. The factors increasing the surgical risk include higher age, comorbidities, size and location of the tumor and its relation to the major vessels.

Key words:
meningeal neoplasms – meningioma – cerebral ventricles – cerebral ventricle neoplasms – lateral ventricles – third ventricle – fourth ventricle

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Chinese summary - 摘要

脑室内脑膜瘤 - 一项19例手术病例的回顾性研究

目标：

脑室内脑膜瘤是一种罕见的肿瘤，在捷克的文献中没有得到充分的说明。本文的目的是向读者介绍脑室内脑膜瘤典型的临床表现，诊断，手术治疗及其并发症。此外，本文还对已发表的文献进行了基本回顾，并与近期发表的国际文献中的结果做了对比。

材料和方法：

回顾性分析了2002年至2015年我院收治的脑室内脑膜瘤19例患者的资料，平均随访3年零5个月。被试的平均年龄是49岁。妇女患病次率会2.8倍于常人。本文回顾性分析了医疗档案，临床影像学检查结果，手术干预及其预后等数据。

结果：

最常见的症状是头痛（53％）。最常见的（89％）脑膜瘤位于侧脑室。手术一般采用枕下入路手术，所有患者均完成了根治性切除。84%的患者的症状和迹象得到了解决。至于永久性并发症，最常见的是癫痫发作（11％）、同向性偏盲（5％）和表达性淋巴障碍（5％）。我们的数据显示有一次（5％）复发。就高度潜在手术风险而言，我们用Leksell伽马刀照射复发部位。

结论：

症状性脑室内脑膜瘤治疗的金标准是显微手术切除。在复发的情况下，立体定向放射手术也是一种选择。无症状肿瘤可被观察到。增加手术风险的因素包括：较高的年龄，并发症，肿瘤的大小和位置及其与主要血管的关系。

关键词：

脑膜肿瘤 - 脑膜瘤 - 脑室 - 脑室肿瘤 - 侧脑室 - 第三脑室 - 第四脑室

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