Paramedian transparietal approach to a dominant hemisphere intraventricular meningioma: illustrative case
| Autor: | John P. Andrews, Philip V. Theodosopoulos, Mitchel S. Berger, Tarun Arora |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
intraventricular
medicine.medical_specialty DTI = diffusion tensor imaging intraventricular meningioma business.industry Neurosciences SLF = superior longitudinal fasciculus paramedian approach General Medicine atrial meningioma Brain Disorders Brain Cancer Intraventricular Meningioma AF = arcuate fasciculus Rare Diseases MRI = magnetic resonance imaging Medicine Biomedical Imaging Radiology dominant hemisphere business 3D = three dimensional Dominant hemisphere Cancer |
| Zdroj: | Journal of neurosurgery. Case lessons, vol 2, iss 7 |
| Popis: | BACKGROUND Meningiomas of the atrium of the lateral ventricle present a unique operative challenge. Parietal transcortical approaches have been described with an oblique approach, but a strictly paramedian approach may offer advantages in a dominant hemisphere atrial meningioma. OBSERVATIONS The patient presented with several weeks of intermittent headaches. Magnetic resonance imaging (MRI) showed an enhancing intraventricular mass in the atrium of the left lateral ventricle. Three-dimensional reconstructions were created from a preoperative MRI, with 1-mm slices for neuronavigation. Diffusion tensor imaging (DTI) was obtained, and tracts were reconstructed in the patient’s three-dimensional brainspace. DTI tractography delineated a paramedian transparietal corridor devoid of functional white matter tracks. The patient was positioned supine, in a semislouch position. A left parietal craniotomy was performed. Neuronavigation identified a gyrus posterior to the sensory cortex, anterior to the optic radiations and medial to superior longitudinal and arcuate fasciculus fiber tracts. The tumor was debulked to allow mobilization to coagulate capsular blood supply. Gross total resection was achieved. The patient was discharged postoperatively on day 3 without neurological deficits. LESSONS A paramedian transparietal approach to a dominant hemisphere meningioma of the lateral ventricle can be a safe and effective way to resect tumors in this anatomically unique operative corridor. |
| Databáze: | OpenAIRE |
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