Tumors at the trigone of the lateral ventricle--clinical analysis of eight cases.

Tumors at the trigone of the lateral ventricles are relatively rare. The authors have operated on eight cases with trigonal tumors during a 10-year period. Four cases were true intraventricular tumors arising from the ventricular walls, consisting of two meningiomas, one cavernous angioma, and one choroid plexus papilloma. On the other hand, the remaining four cases were paraventricular tumors originating in the adjacent brain and consisted of three astrocytomas and one glioblastoma multiforme. Although these trigonal tumors were readily detected with computed tomographic (CT) scanning, differential diagnosis was difficult because of their similar appearances on CT scans. The initial symptoms were headache in seven, and the neurological examination revealed personality changes, choked disc, visual field defects, hemiparesis, etc., in four, and no deficits in the remaining four cases. All cases were operated on via superior or middle temporal gyrus incision, and the surgical results were good except for one case who died of postoperative brain edema. In the four cases with tumors located in the dominant hemisphere, two were left with sensory aphasia, dyslexia, dyscalculia, and hemianopsia which improved within 6 months. In these two cases, postoperative CT scans revealed cerebrospinal fluid retention with severe edema along the surgical route which disappeared spontaneously within 3 months. We consider that the temporal gyrus incision was the safest approach, even though the tumor was located in the dominant side.