Lateral-trigonal intraventricular tumors. A new operative approach

With the introduction of additional diagnostic methods, computerized axial tomography, interventricular tumors are discovered at a time when these lesions are still small and may have presented very insignificant or no clinical symptoms. If the lesion is a benign tumor as a meningioma and within the lateral ventricle of the dominant hemisphere a very difficult problem persents itself to the patient and surgeon. Shall they wait until the tumor reaches such a size to make more permanent symptoms to justify entering the ventricle by the conventional approach through the middle temporal gyrus and leaving the patient at least with a visual field defect? Or should surgery be postponed until the ventricle especially the temporal horne is enlarged due to blockage by the tumor, making the operative procedure technically easier? The authors present a method used in three atrial trigonal meningiomas of the dominant hemisphere which did not result in any neurological deficit which was not present before surgery and which abolished paroxysmal attacks of hemianopsia and severe headaches in one patient. The latter patient was believed to have suffered from migraine for 2 1/2 years.