Nakajo Kosuke, Morisako Hiroki, Ichinose Tsutomu, Goto Takeo
Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Osaka, Japan.
NMC Case Rep J. 2025 Jun 11;12:267-273. doi: 10.2176/jns-nmc.2025-0031. eCollection 2025.
The trigone of the lateral ventricle is deep and surrounded by eloquent gyri and subcortical fibers. Resection of intraventricular trigone tumors has therefore been challenging, and the optimal surgical approach to the trigone of the lateral ventricle remains controversial. Three patients with large intraventricular trigone meningioma (≥4 cm in diameter) underwent surgical excision using a combined transtemporal and high-parietal approach at Osaka City University Hospital between July 2016 and January 2021. Clinical and imaging studies, as well as surgical complications, were retrospectively reviewed based on medical records from our institution. We also reviewed 153 patients with intraventricular trigone meningioma from 11 reports in the literature and assessed pre- and postoperative symptoms. Gross total resection of the tumor was achieved in all cases. None of the patients showed deterioration of neurological symptoms at 3 months after tumor resection, although one patient experienced transient language dysfunction several weeks after surgery. No cases showed recurrence or required additional therapy. According to our literature review, postoperative visual field defects are more likely to persist than postoperative language dysfunction at 3 months postoperatively. In conclusion, combining the transtemporal and high-parietal approaches appears to be useful for treating large intraventricular trigone meningioma. Postoperative language dysfunction after resection of intraventricular trigone meningioma may tend to resolve more rapidly than postoperative visual field defect.
侧脑室三角区较深，周围环绕着功能明确的脑回和皮质下纤维。因此，切除脑室内三角区肿瘤具有挑战性，并且对于侧脑室三角区的最佳手术入路仍存在争议。2016年7月至2021年1月期间，大阪市立大学医院的3例大型脑室内三角区脑膜瘤（直径≥4 cm）患者采用经颞叶和高顶叶联合入路进行了手术切除。根据我院的病历，对临床和影像学研究以及手术并发症进行了回顾性分析。我们还回顾了文献中11篇报道的153例脑室内三角区脑膜瘤患者，并评估了术前和术后症状。所有病例均实现了肿瘤的全切除。尽管有1例患者在术后数周出现短暂性语言功能障碍，但所有患者在肿瘤切除后3个月均未出现神经症状恶化。没有病例出现复发或需要额外治疗。根据我们的文献综述，术后3个月时，术后视野缺损比术后语言功能障碍更可能持续存在。总之，经颞叶和高顶叶联合入路似乎对治疗大型脑室内三角区脑膜瘤有用。脑室内三角区脑膜瘤切除术后的语言功能障碍可能比术后视野缺损更容易较快恢复。
