• Danica Grujicic, Luigi Maria Cavallo, Teresa Somma, Rosanda Illic, Mihailo Milicevic, Savo Raicevic, Milica Skender Gazibara, Alessandro Villa, Dragan Savic, Domenico Solari, and Paolo Cappabianca.
• Clinical Center of Serbia, Clinic of Neurosurgery, Medical Faculty University of Belgrade, Belgrade, Serbia.
• World Neurosurg. 2017 Jan 1; 97: 178-188.

BackgroundPrimary intraventricular meningiomas (IVMs) make up 0.5%-5% of all intracranial meningiomas and represent one of the most challenging lesions in neurosurgery.MethodsBetween 1990 and 2013, 42 patients (30 female, 12 male; mean age, 43.6 years) underwent resection of their IVM. The removal was performed by a posterior parietal approach in 19 of the 40 lateral ventricle tumors, and 1 third ventricle meningioma. The transcallosal approach was used for 3 meningiomas, and patients with other lesions underwent temporal (7 cases) and temporoparietal approaches (12 patients), respectively.ResultsThe most common presenting signs were increased intracranial pressure (83.3%), visual impairment (78.6%) and cognitive changes (50%). Forty lesions (95.2%) arose in the lateral ventricles, and 2 (4.8%) in the third ventricle, ranging in size from 3 to 10 cm. Total removal was achieved in 39 cases and the pathology report disclosed World Health Organization grade I lesions in 41 cases. Hydrocephalus, cerebrospinal fluid leakage, and cerebral edema were the postoperative complications (7.15%); 1 patient died of respiratory problems not directly related to surgery. Thirty-five patients (83.3%) showed a 6-month Glasgow Outcome Scale of 5. One patient, who underwent partial resection, presented a recurrence after 1 year that remained stable until last follow-up.ConclusionsIVMs usually reach a large size before being diagnosed. Surgical treatment is the most suitable option and total removal should represent the main goal of the procedure. The posterior parietal transulcal approach and the temporoparietal approach are the most common surgical routes used in our series.Copyright © 2016. Published by Elsevier Inc.

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