Clinical outcome after microsurgical resection of intraventricular trigone meningiomas: a single-centre analysis of 20 years and literature overview

Outcome and treatment-associated morbidity analysis of trigone meningioma surgery. We retrospectively assessed 27 neurosurgically treated patients (median age 63 years, range 15–84) between 1999 and 2019. The median preoperative Karnofsky Performance Scale (KPS) was 80 (range 20–100), and the majority (78%) suffered from tumour-specific symptoms. The most frequent symptoms were aphasia (n = 6), visual field deficits (n = 5), and increased intracranial pressure (n = 5). The median tumour volume was 11.2 cm3 (range 3.9–220.5). The most common approaches were the transtemporal (n = 17) and transparietal routes (n = 5). At last follow-up (median follow-up 35 months, range 3–127), the median KPS was 90 (range 30–100); eleven (42%) patients had improved, nine (35%) were unchanged, six (23%) had worsened, and one was lost to follow-up. One year after surgery, 18/21 (86%) patients had retained an activity level similar or improved compared with preoperatively. No surgery-related mortality was recorded. Postoperative new neurological deficits were seen in 13 (48%) patients; eight suffered from permanent, most commonly motor deficits (n = 4), and five of transient deficits. Permanent new motor deficits improved in the majority of affected patients (3/4) over time. New deficits were more often seen for transtemporal (8/17) than transparietal approaches (1/5). Patients with postoperative permanent new deficits had a significantly worse KPS at last follow-up (p < 0.001). The transtemporal and transparietal approaches provide good access, but the latter might provide for a better risk profile. Patients show favourable outcome, but there is a considerable risk for new neurological deficits. This must be taken into consideration for oligosymptomatic patients.