Supratentorial intraventricular tumors in childhood

We report on a series of 21 infants and children with tumors of the supratentorial ventricular system, all of whom were assessed by computed tomography and underwent operation using microsurgical techniques. In 7 cases the tumor was found in the 3rd ventricle, whereas the lateral ventricles were involved in the others. Surgical access to the lateral ventricles and the anterior portion of the 3rd ventricle was gained by standard intergyral cortical incision in the precentral or postcentral regions and via the foramen of Monro. The posterior portions of the lateral ventricle of the dominant hemisphere as well as the posterior part of the 3rd ventricle were exposed with minimal risk, using the occipital midsagittal supratentorial route. Following this technique, total removal of the tumors was possible in all cases without substantial postoperative morbidity. After a follow-up period of 6 months to 9 years all patients are in good or excellent neurological condition. Tumor recurrences were not encountered, although a definitive statement cannot be made in some patients with malignant lesions.