Trigone ventricular meningiomas: Is it possible to achieve good results even in the absence of high tech tools?

BACKGROUND: Intraventricular meningiomas constitute 2% of intracranial meningiomas, representing a challenging disease for neurosurgeons; we report our experience through a case series, emphasizing surgical approaches and results. METHODS: Between 2009 and 2012, four patients underwent microsurgical resection in our department. Clinical and imaging findings, surgical approaches, outcomes, and follow-up were analyzed. RESULTS: Four patients (three females and one male) were included and the signs of intracranial hypertension were the main clinical presentation in all cases. The parietal approach through intraparietal sulcus was performed in 3 cases and parieto-occipital interhemispheric surgical route in 1 case. Gross total resection was achieved in all the patients without additional deficits and without the aid of neuronavigation, intraoperative monitoring, and intraoperative magnetic resonance imaging. CONCLUSION: Gross total resection is the gold standard treatment for such tumors and the intraparietal sulcus approach is an excellent choice for most of the cases. Careful anatomical knowledge contributes to a safer procedure even in the absence of high tech equipment assistance.