Incidence and Surgical Outcome of Intraventricular Tumors at a Tertiary Care Hospital in Lahore, Pakistan

Objectives:  To determine the incidence and outcome of intraventricular tumors treated micro-surgically at the Punjab Institute of Neurosciences, Lahore, Pakistan. Materials and Methods:  A retrospective study of a series of 42 patients with the initial diagnosis of intraventricular tumors who underwent microsurgical resection over a period of 04 years. The extent of resection was decided by post-operative imaging (CT Brain), performed on immediate or 1st post-op day, and by MRI on outdoor follow-up after an average of 4 weeks. Post-operative complications and the Glasgow outcome scale were also recorded. Results:  The majority of patients presented with nonspecific symptoms. 47.6% patients presented with headache, nausea/vomiting (40.5%), decreased vision (21.4%), fits (19%) and hydrocephalus (9.52%).29patients (72.5%) underwent microsurgical excision through the anterior transcortical approach, followed by 08 (19.05%) via the posterior transcortical approach. GTR was achieved in 33 (78.57%). Based on histopathology reports, 14 (33.3%) were ependymomas, 11(26.2%) meningiomas, 07 (16.67%) sub-ependymomas, 5 (11.9%) central neurocytomas, and 2(4.76%) Choroid Plexus Papilloma. Significant postoperative intraventricular bleed was noted in 04 (9.52%) patients, minor I/V bleed in 06 (14.28%), hydrocephalus in 07 (16.67%), subdural collection in 02 (4.76%), and motor deficit in 03 (7.15%) patients. Based on Glasgow Outcome Scale, 32 (76.2%) had GOS5/5, 7 (16.67%) with GOS 4/5, while 02 patients expired in the postoperative period. Conclusion:  Intraventricular tumors require special neurosurgical consideration. Early diagnosis, better preoperative planning, and an adequate microsurgical approach are necessary to achieve maximum safe resection and improvement in patients’ symptoms and overall condition.