Lateral ventricular meningiomas (LVMs) are especially rare, and they often remain "silent" until they become very large. Several surgical approaches exist, but the optimal surgical strategy for them remains a challenge. The incidence, clinical features, radiological manifestations, pathological findings, and especially the surgical strategy in 21 patients with LVMs were analyzed retrospectively. The mean age of patients was 42.7 years (range, 17 to 78 years). Raised intracranial pressure was the main presenting symptom. The definite diagnosis of LVMs in most cases was made by computed tomography (CT) or magnetic resonance imaging (MRI). Six patients were subjected to plain CT scans, 15 to contrast MR scans, and 4 to a magnetic resonance angiogram (MRA). Large tumors were seen in most cases with an average diameter of more than 4.3 cm. Of the 21 cases of LVMs in our series, LVMs were resected in 16 cases via a posterior parieto-occipital transcortical approach, 2 cases via a transcallosal approach, and 3 cases via a posterior middle temporal gyrus approach. In 8 out of 21 cases, the tumors were located in the left lateral ventricle. The gross total surgical excision was achieved in 18 (86%) patients, and all LVMs were pathologically confirmed to be benign. Nine patients were followed up (range: 11 months-4.6 years). Eight (88.9%) cases obtained good recovery and one (11.1%) obtained moderate disability. Four approaches are available for the surgical treatment of LVMs. The choice of surgical approaches depends on tumor location, laterality, size and extension, and the function of the brain must be taken into account. Intracapsular resection and piecemeal resection of LVMs can be safely and easily performed. Preoperative MRA scan is important to know the feeder of LVMs and peripheral blood supply.
Adolescent ; Adult ; Aged ; Female ; Humans ; Intracranial Hypertension ; diagnosis ; pathology ; surgery ; Lateral Ventricles ; blood supply ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms ; blood supply ; diagnosis ; pathology ; surgery ; Meningioma ; blood supply ; diagnosis ; pathology ; surgery ; Middle Aged ; Neurosurgical Procedures ; Retrospective Studies ; Tomography, X-Ray Computed ; Tumor Burden

Frontal meningiomas may present only with psychological symptoms that resemble depression, anxiety states, hypomania and schizophrenia. Herein, we present the case of a 55-year-old man who was initially thought to have depression and bipolar disorder, but was eventually diagnosed with frontal lobe syndrome caused by a giant frontal meningioma.
Alcohol Drinking ; adverse effects ; Bipolar Disorder ; chemically induced ; diagnosis ; Brain Neoplasms ; diagnosis ; surgery ; Depression ; chemically induced ; diagnosis ; Diagnosis, Differential ; Frontal Lobe ; pathology ; Humans ; Male ; Meningeal Neoplasms ; diagnosis ; surgery ; Meningioma ; diagnosis ; surgery ; Middle Aged ; Syndrome

OBJECTIVETo explore an effective method for further improving the surgical results of treatment of olfactory groove meningiomas.

METHODSSixty seven cases of olfactory groove meningiomas were treated by microneurosurgery, among which fifty seven were de novo cases, eight were recurrent tumors and the other two re-recurrent cases. Modified Derome approach was used in 12 cases, bilateral subfrontal approach in 28 cases, modified pterional approach in 21 cases and unilateral subfrontal approach in six cases. Tumors were resected microsurgically with radical removal of invaded dura, bone, and paranasal sinus mucosa. Reconstruction was performed in patients with skull base defect.

RESULTSSimpson grade I removal was accomplished in 59 cases, grade II in seven cases and grade IV in one case. Among 57 patients with de novo tumor, Simpson I resection was accomplished in 54 cases. Postoperative rhinorrhea and intracranial infection occurred in one case and was cured after temporal lumbar CSF drainage and antibiotic therapy. Two patients (2.9%) died within one month after operation, i.e.one aged patient of heart failure and the other of severe hypothalamus complication. Forty seven patients (72.3%) were followed up from one to ten years with an average of five years and four months. With the exception of two cases died, among the alive 45 patients, there were only three patients with tumor recurrence, which had undergone Simpson II or IV tumor resection. No recurrence was found in cases with Simpson I tumor removal. Previous blurred vision was not improved in three patients, hemiparalysis in two patients, and the other patients recovered well, resuming previous jobs or being able to take care themselves.

CONCLUSIONSTotal tumor removal (Simpson I) should be the surgical goal for treatment of olfactory groove meningiomas, especially for de novo cases. An appropriate approach is fundamental in the effort to remove an OGM totally. Appropriate anterior skull base reconstruction with vascularized material is important and mandatory.

Adult ; Aged ; Cerebrospinal Fluid Rhinorrhea ; etiology ; Dura Mater ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms ; diagnosis ; pathology ; surgery ; Meningioma ; diagnosis ; pathology ; surgery ; Microsurgery ; adverse effects ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; Paranasal Sinuses ; pathology ; surgery ; Reconstructive Surgical Procedures ; Skull Base ; pathology ; surgery

Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Ependymoma ; pathology ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Meningioma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Mucin-1 ; metabolism ; Oligodendroglioma ; pathology ; Tomography, X-Ray Computed ; Vimentin ; metabolism ; Young Adult

Adolescent ; Adult ; Brain Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Meningioma ; diagnosis ; metabolism ; pathology ; surgery ; Middle Aged ; Mucin-1 ; metabolism ; Neoplasm Recurrence, Local ; Reoperation ; Retrospective Studies ; Tomography, X-Ray Computed ; Vimentin ; metabolism ; Young Adult

Adult ; Aged ; Antigens, CD34 ; metabolism ; Chondrosarcoma, Mesenchymal ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hemangiopericytoma ; metabolism ; pathology ; radiotherapy ; surgery ; Humans ; Male ; Meningeal Neoplasms ; metabolism ; pathology ; radiotherapy ; surgery ; Meningioma ; metabolism ; pathology ; Middle Aged ; Neoplasm Recurrence, Local ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Solitary Fibrous Tumors ; metabolism ; pathology ; Vimentin ; metabolism ; Young Adult

Adult ; Diagnosis, Differential ; Humans ; MART-1 Antigen ; metabolism ; Magnetic Resonance Imaging ; Male ; Medulloblastoma ; metabolism ; pathology ; Melanocytes ; pathology ; Melanoma ; diagnosis ; metabolism ; pathology ; surgery ; Melanoma-Specific Antigens ; metabolism ; Meningeal Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Neoplasms, Multiple Primary ; diagnosis ; metabolism ; pathology ; surgery ; Neurilemmoma ; metabolism ; pathology ; Nevus of Ota ; diagnosis ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism ; Skin Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Adult ; Desmin ; metabolism ; Diagnosis, Differential ; Diagnostic Errors ; Humans ; Male ; Melanoma-Specific Antigens ; metabolism ; Meningeal Neoplasms ; metabolism ; pathology ; radiotherapy ; surgery ; Meningioma ; metabolism ; pathology ; Paraganglioma ; metabolism ; pathology ; Sarcoma, Alveolar Soft Part ; metabolism ; pathology ; radiotherapy ; surgery ; Sarcoma, Clear Cell ; metabolism ; pathology ; Tomography, X-Ray Computed ; Vimentin ; metabolism

Antigens, CD34 ; metabolism ; Carcinoma, Renal Cell ; metabolism ; pathology ; Central Nervous System Neoplasms ; metabolism ; pathology ; surgery ; ultrastructure ; Diagnosis, Differential ; Ependymoma ; metabolism ; pathology ; Hemangioblastoma ; metabolism ; pathology ; surgery ; ultrastructure ; Humans ; Meningeal Neoplasms ; metabolism ; pathology ; Meningioma ; metabolism ; pathology ; Mutation ; Neoplasm Recurrence, Local ; Prognosis ; Receptor, Epidermal Growth Factor ; metabolism ; Vimentin ; metabolism ; von Hippel-Lindau Disease ; genetics ; metabolism ; pathology ; surgery

Diagnosis, Differential ; Ependymoma ; metabolism ; pathology ; Female ; Hemangioblastoma ; metabolism ; pathology ; Humans ; Ki-67 Antigen ; metabolism ; Meningeal Neoplasms ; metabolism ; pathology ; surgery ; Meningioma ; metabolism ; pathology ; surgery ; Middle Aged ; Mucin-1 ; metabolism ; Neoplasm Recurrence, Local ; Vimentin ; metabolism