Functional Neuronavigation-Guided Transparieto-Occipital Cortical Resection of Meningiomas in Trigone of Lateral Ventricle

World Neurosurg. 2015 Sep;84(3):756-65. doi: 10.1016/j.wneu.2015.04.057. Epub 2015 May 7.

Abstract

Background: This study investigated whether functional neuronavigation can be used to remove lesions in the lateral ventricle while preserving patients' neurologic functionality.

Methods: A total of 60 patients with lateral ventricular meningiomas were divided into study and control groups (n = 30 each). Diffusion tensor and blood oxygenation level-dependent functional magnetic resonance imaging were used for fiber tracking and eloquent cortex localization, respectively, in the study group. The surgical approach was based on coregistered data sets from 3-D lesion and brain structure reconstructions. Patients in the control group underwent anatomic neuronavigation-guided surgery. The patients' demographics, degree of resection, visual field, language score, movement, preoperative and postoperative Karnofsky Performance Status (KPS) scores, and surgical complications were recorded.

Results: Tumors were completely removed in both groups. Patients in the study group had a higher rate of visual field preservation than controls (P = 0.01). The two groups had similar motor and language functions after surgery, except that fewer cases of transient aphasia were observed in the former (P < 0.05). KPS scores for the study and control groups were 80 (70-80) and 70 (60-70), respectively (P < 0.01), at 2 weeks and 90 (80-100) and 85 (70-90), respectively (P = 0.022), at 3 months after surgery.

Conclusions: Functional neuronavigation preserved neurologic functionality and was especially beneficial for protecting optical functionality and for the rapid recovery of patients.

Keywords: Functional neuronavigation; Image-guided surgery; Meningioma; Optic radiation.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Diffusion Tensor Imaging
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Lateral Ventricles / surgery*
  • Male
  • Meningioma / surgery*
  • Middle Aged
  • Neuronavigation / methods*
  • Neurosurgical Procedures / methods*
  • Occipital Lobe / surgery*
  • Parietal Lobe / surgery*
  • Postoperative Complications / epidemiology
  • Surgery, Computer-Assisted / methods*
  • Treatment Outcome
  • Visual Fields
  • Young Adult