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Journal of Neurosurgical Sciences 2019 Oct 07

DOI: 10.23736/S0390-5616.19.04759-3

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Microsurgical resection of trigone ventricular meningiomas using the parieto-occipital approach: a retrospective analysis of 47 cases and literature review

Da-Peng WANG 1 , Wei HE 2, Xiao-Li SHEN 2, Jian HAI 1

1 Department of Neurosurgery, Tong Ji Hospital, Tong Ji University School of Medicine, Shanghai, China; 2 Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China


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BACKGROUND: To investigate the risk factors of preoperative and postoperative treatment for trigone ventricular meningioma and the clinical efficacy of microsurgical resection of the neoplasm using the parieto-occipital approach.
METHODS: Forty-seven trigone ventricular meningiomas were resected using the parieto-occipital approach in one institute from January 2015 to January 2019. Patients were postoperative followed up for 3 months to 3 years. Karnofsky Performance Status (KPS) and Glasgow Coma Scale (GCS) were used to assess patient's performance status and consciousness. Clinical data including patients’ characteristics, surgical procedure, and postoperative management were retrospectively analyzed.
RESULTS: Microsurgery achieved total removal of the tumor in 46 cases with no obvious residue (97.9%), and subtotal removal in 1 case (2.1%). No deaths occurred. Preoperative symptoms of neurology were significantly improved. There was a significant difference in preoperative KPS and postoperative KPS (P<0.05). No difference was found in GCS. Compared to patients with peritumoral brain edema (PTBE), KPS of patients without PTBE was significantly increased (P<0.05).
CONCLUSIONS: PTBE may be a risk factor for preoperative neurological symptoms. Furthermore, the parieto-occipital approach is a safe and effective surgical approach in resecting trigone ventricular meningioma.


KEY WORDS: Meningioma; Lateral ventricular; Trigone; Parieto-occipital approach; Peritumoral brain edema

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