Primary Tumors of the Lateral Ventricles of the Brain
L. DănăilăOriginal article, no. 5, 2013
Background: The lateral ventricles are located in the center ofthe brain. Each ventricle lies in contact with five criticalneural structures: the caudate nucleus, the thalamus, thefornix, the corpus callosum, and the genu of internal capsule.The authors report their experience in primary tumors of thelateral ventricles of the brain by analysing the symptomatology,the surgical treatment, the complications and the postoperativeresults.Objective: To determine the importance of the surgicaltechnique on the morbidity and the recurrence of lateralventricles tumors. Total surgical resection followed by radiotherapyand or chemotherapy had been the main objective inthe cases of anaplastic tumors.Methods: This retrospective study makes reference to 202 primary tumors of the lateral ventricles operated by LeonDanaila between 1982 and 2012. The respective analysis isbased on the operative approaches and on the extent ofresection. The surgical access routes were the interhemispherictranscallosal approach and the transcorticalapproach.Results: A number of 177 (87%) of the primary tumors of thelateral ventricles were benign (low grade lesions), while 25(12.37%) of them were anaplastic. The most frequent tumorswere ependymomas, astrocytomas, subependymomas, choroidplexus papillomas and meningiomas. Out of the total of 202tumor cases, 164 (81.18%) were discharged with very good andgood results, 35 (17.32%) were left with neurological deficits,and 3 (1.48%) died. A significant proportion of the patientsundergoing surgery develop cerebrospinal fluid outflowobstruction, and this fact made the postoperative mountingof a number of ventricular shunts necessary.Conclusion: The majority of these tumors were benign, with arelatively slow growth rate. Owing to this fact, the preoperativedimensions of the tumors were of several centimeters. Theaverage age of the patients was lower than that of those withsimilar lesions located intraparenchymatously. The symptomswere determined by the ventricular outflow obstruction and bythe affectation of the periventricular structures. Interhemispherictranscallosal and transcortical approaches were the bestsurgical access routes.
