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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Intraventricular meningioma resection and visual outcomes
John P Andrews1, Daniel D Cummins1, Ramin A Morshed1
1Departments of1Neurological Surgery and.
Journal of Neurosurgery
|October 25, 2023
Summary
Intraventricular meningioma (IVM) surgery can cause visual field deficits (VFDs). Diffusion tensor imaging (DTI) may help surgeons identify safe corridors to prevent these new VFDs during tumor resection.
Area of Science:
- Neurosurgery
- Neuro-oncology
- Ophthalmology
Background:
- Intraventricular meningiomas (IVMs) are rare tumors located deep within the lateral ventricles.
- Surgical resection of IVMs presents significant challenges due to their location.
- Visual field deficits (VFDs) are a known risk, occurring preoperatively due to mass effect or postoperatively from surgical approach.
Purpose of the Study:
- To review surgical outcomes for IVM resection.
- To specifically analyze the incidence and characteristics of VFDs following IVM surgery.
- To evaluate the role of preoperative imaging in preventing surgical VFDs.
Main Methods:
- Retrospective review of 32 adult patients undergoing IVM resection (1996-2021).
- Preoperative diffusion tensor imaging (DTI) used to reconstruct optic radiations.
- Documentation of VFD course and resolution.
Main Results:
- Gross-total resection achieved in 93.8% of patients.
- Preoperative VFDs present in 6 patients, with 5 resolving post-surgery.
- New persistent surgical VFDs occurred in 15.6% of patients, primarily with transtemporal approaches before routine DTI use.
Conclusions:
- New surgical VFDs are a notable complication after IVM resection.
- Preoperative DTI can visualize optic radiation distortion.
- DTI may help identify safe surgical corridors, potentially preventing postoperative VFDs.
