Meningiomas of the lateral ventricle - a report of 15 cases

Lateral ventricular meningiomas are rare tumours that pose considerable surgical challenge. This study attempts to analyse some of the important clinical features of these tumours and review technical considerations in surgery for lateral ventricular meningiomas. A retrospective analysis of the case records of patients with lateral ventricular meningiomas operated in our institute since 1998 with a minimum of one year follow up was done. The variables analysed included age, sex, clinical presentation, imaging characteristics, histopathology and operative details. Outcome was analysed using the Glasgow outcome score (GOS). Fifteen patients with a mean age of 40.6 years formed the study group. A female preponderance was observed (M:F 5:10). Raised intracranial pressure was the predominant symptom at presentation (10/15; 66%) followed by visual field deficits (6/15; 40%) and contralateral motor deficits (5/15; 33.3%). One patient presented with evidence of intratumoural bleed. The tumour was on the right side in 7 patients and on the left side in 8 patients. The lesion was located in the trigone of the lateral ventricle in 13 patients and in the body of the ventricle in two. The tumours were excised through a parietooccipital approach in 11 (73.33%) patients and through a middle temporal gyrus approach in 4 (26.66%).The tumour recurred in 2 patients, both tumours being histologically fibroblastic variants. Fresh operative complications included motor deficits in 3, contralateral homonymous hemianopia in 2, dysphasia in 1, refractory seizures in 2 and loculated hydrocephalus in one. We had no operative mortality. At last follow-up for 10 patients were in GOS 5, two were in GOS 4 and three in GOS 3. Lateral ventricular meningiomas are difficult tumours to operate. Total surgical excision through a superior parietal lobule or middle temporal gyrus approach is possible in most cases with minimal morbidity.