Anatomical surgical approach to lateral vetricle masses and histopathological findings of the brain.

Background: The selection of surgical approach to the lateral ventricular masses includes difficulties due to their deep localizations, close proximity to the vascular and the eloquent brain structures. The most appropriate approach that should be chosen in surgical treatment of lateral ventricular masses is still controversial. In this study, the factors in the choice of surgical approach to the lateral ventricle masses and the results of them were investigated.

Materials and methods: In this study, 80 patients who underwent surgery in our clinic due to the lateral ventricular masses were retrospectively analyzed between the years 2002-2013. All of the cases were evaluated in terms of clinical and neuroradiological results pre and postoperatively. In 24 cases the anterior interhemispheric transcallosal, in 4 cases the posterior interhemispheric transcallosal, in 30 cases the posterior interhemispheric precuneal, in 14 cases the transcortical and in 8 cases the combined surgical approaches were performed.

Results: Gender distribution of the cases were 45 male/35 female and the mean age of them was 31.7 years (7 month - 73 years). In 64 patients the gross total resection was performed, whereas in 16 patients subtotal resection was performed due to the infiltration of eloquent brain areas. In the histopathological examination; 52 neuroepithelial, 8 mixed neuroglial, 3 meningeal, 2 lympho-hematopoietic system, 1 pine blastoma, 1 germ cell, 5 metastatic and 8 other benign masses were observed. After surgery, additional neurological deficits developed in 9 patients. The mortality was observed in 6 patients postoperatively. The average follow-up time was 13 (1-83) months.

Conclusions: The essential factors which affect the results of surgical treatment of lateral ventricular masses are; the size of the mass, histopathology, location, extension, and the relationship to the neurovascular structures. The goal of surgery is to provide the histopathological diagnosis, gross total resection, if it is possible, and to normalize the flow of cerebrospinal fluid by eliminating the mass effect of pressure.