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Updated: Jul 12, 2025
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Intraventricular meningioma resection and visual outcomes
John P Andrews1, Daniel D Cummins1, Ramin A Morshed1
1Departments of1Neurological Surgery and.
Objective:
Intraventricular meningiomas (IVMs) of the lateral ventricle are rare tumors that present surgical challenges because of their deep location. Visual field deficits (VFDs) are one risk associated with these tumors and their treatment. VFDs may be present preoperatively due to the tumor and mass effect (tumor VFDs) or may develop postoperatively due to the surgical approach (surgical VFDs). This institutional series aimed to review surgical outcomes following resection of IVMs, with a focus on VFDs.
Methods:
Patients who received IVM resection at one academic institution between the years 1996 and 2021 were retrospectively reviewed. Diffusion tensor imaging (DTI) reconstructions of the optic radiations around the tumor were performed from preoperative IVM imaging. The VFD course and resolution were documented.
Results:
Thirty-two adult patients underwent IVM resection, with gross-total resection in 30 patients (93.8%). Preoperatively, tumor VFDs were present in 6 patients, resolving after surgery in 5 patients. Five other patients (without preoperative VFD) had new persistent surgical VFDs postoperatively (5/32, 15.6%) that persisted to the most recent follow-up. Of the 5 patients with persistent surgical VFDs, 4 received a transtemporal approach and 1 received a transparietal approach, and all these deficits occurred prior to regular use of DTI in preoperative imaging.
Conclusions:
New surgical VFDs are a common neurological deficit after IVM resection. Preoperative DTI may demonstrate distortion of the optic radiations around the tumor, thus revealing safe operative corridors to prevent surgical VFDs.
Insights
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.
