Neuroimaging and functional navigation as potential tools to reduce the incidence of surgical complications of lateral ventricular meningiomas

Clin Neurol Neurosurg. 2011 Sep;113(7):564-9. doi: 10.1016/j.clineuro.2011.03.017. Epub 2011 May 6.

Abstract

Objective: Post-operative complications are common following treatment for meningiomas in the lateral ventricles because it is unavoidable to disrupt the integrity of the brain during surgery. This study discusses our experience with strategies for reducing these complications.

Method: Twenty-seven cases of lateral ventricular meningiomas treated surgically were summarized. The surgical corridors of 11 patients were selected according to the traditional anatomical markers. Navigation technologies including neuronavigation, ultrasonography, neuro-endoscopy, fMRI and intraoperative brain mapping were used in the other 16 patients. The post-operative Karnofsky Performance Status (KPS) of patients with or without navigation were compared at 1 week and 3, 6 and 12 months.

Results: Except for one patient who died from postoperative intracerebral hemorrhage, most of the preoperative disorders improved after surgery. Although only 4 out of 27 cases suffered from permanent complications of visual field defect or epilepsy, novel postoperative complications were found in 8 of 11 patients without navigation but in only 5 of 16 patients with navigation. The post-operative KPS of patients with navigation were better than those without navigation at 1 week and 3 months after surgery.

Conclusion: The use of neuroimaging and functional navigation technologies may effectively lower the incidence of postoperative complications.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angiography, Digital Subtraction
  • Brain Mapping
  • Cerebral Ventricle Neoplasms / diagnostic imaging
  • Cerebral Ventricle Neoplasms / pathology*
  • Cerebral Ventricle Neoplasms / surgery*
  • Diffusion Tensor Imaging
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocephalus / etiology
  • Hydrocephalus / pathology
  • Karnofsky Performance Status
  • Magnetic Resonance Imaging
  • Male
  • Meningioma / diagnostic imaging
  • Meningioma / pathology*
  • Meningioma / surgery*
  • Middle Aged
  • Monitoring, Intraoperative
  • Neuronavigation / methods*
  • Neurosurgical Procedures / methods*
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy*
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography
  • Vomiting / etiology
  • Young Adult