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Lin Z, Zheng D, Liao D, Guan C, Lin F, Kang D, Jiang Z, Ren X, Lin Y. Shunt, endoscopic, and microsurgical management of trapped temporal horn following resection of lateral ventricle trigonal or peritrigonal tumors: A retrospective multicenter study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108643. [PMID: 39241539 DOI: 10.1016/j.ejso.2024.108643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 08/16/2024] [Accepted: 08/24/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVE To investigate the surgical management and outcomes of trapped temporal horn (TTH) following resection of lateral ventricle trigonal or peritrigonal tumors. METHODS Patients who underwent surgical treatment for TTH in three different tertiary centers between 2012 and 2022 were retrospectively studied. The primary outcome was reoperation rate. RESULTS Thirty-one patients were included for analysis. The underlying pathology was meningioma in 17 patients, central neurocytoma in 7, glioma in 4, ependymoma in 2, and cavernous malformation in 1. The median KPS score was 50 (range 10-90) and the mean volume of TTH was 53.1 ± 29.9 cm³ (range 14.8-118.6). Six patients (19.3 %) required multiple operations. A total of 39 procedures were performed, including 28 CSF shunting, 2 endoscopic septostomy, 3 microsurgical fenestration or temporal tip lobectomy via craniotomy, 2 decompressive craniectomy (DC), and 4 shunt revisions. Reoperation rates according to procedure were as follows: 10.7 % (3/28) for CSF shunting, 50 % (1/2) for endoscopic septostomy, 100 % (2/2) for DC, and 0 (0/3) for microsurgical fenestration or temporal tip lobectomy. CSF shunting tended to have a lower reoperation rate compared to other surgical approaches (p = 0.079). The reoperation rate was significantly higher for DC than for other surgical techniques (p = 0.025). CONCLUSION CSF shunting was the most frequently used technique with a relatively low revision rate. Long-term patency can be achieved through endoscopic septostomy in selected patients. Microsurgical fenestration or temporal tip lobectomy should be reserved for refractory cases. DC has limited effectiveness and should not be recommended.
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Affiliation(s)
- Zhiqin Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China; Department of Neurosurgery, Radiotherapy, Longyan First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Dao Zheng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dongxia Liao
- Department of Neurosurgery, Radiotherapy, Longyan First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Celin Guan
- Department of Neurosurgery, Radiotherapy, Longyan First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Fuxin Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Dezhi Kang
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Zhongli Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaohui Ren
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Yuanxiang Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
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Al Risi A, Mathon B, Touat M, Carpentier A, Lefevre E. Management of entrapped temporal horn: Literature review and operative technique for endoscopic fenestration. Clin Neurol Neurosurg 2024; 244:108407. [PMID: 38959784 DOI: 10.1016/j.clineuro.2024.108407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/06/2024] [Accepted: 06/23/2024] [Indexed: 07/05/2024]
Abstract
CONTEXT Entrapment of the temporal horn (TH) is rare condition that can lead to increased intracranial pressure, but there is no consensus on a standard treatment. The aim of this study was to conduct a systematic literature review of the reported cases of TH entrapment and describe our operative technique for endoscopic fenestrations of the lateral ventricle into the basal cisterns. METHODS We searched the databases Pubmed and Google scholar to find all studies reporting cases of entrapped TH and the subsequent treatment. Additionally, we report two illustrative cases of endoscopic fenestration with a step-by-step description of our surgical technique. RESULTS Twenty-nine studies with a total of 67 patients were included in the analysis. The mean age was 36.5 years (SD± 21.9), and the female-to-male ratio was 1.5. The most frequent cause of TH entrapment was post-surgical scarring after tumor surgery (n= 30), and the most commonly reported treatment modality was endoscopic fenestration of the TH (n = 14). We observed an increasing use of endoscopic fenestration over time. CONCLUSION Entrapped TH is a rare condition often requiring surgical treatment. Neuronavigation-guided endoscopic fenestration of the ventricle into the basal cisterns appears to be a safe, efficient, and device-free technique that has gained importance over the past years.
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Affiliation(s)
- Ahmed Al Risi
- Service de Neurochirurgie, Hôpitaux universitaires La Pitié Salpêtrière - Charles Foix, APHP, Paris, France
| | - Bertrand Mathon
- Service de Neurochirurgie, Hôpitaux universitaires La Pitié Salpêtrière - Charles Foix, APHP, Paris, France; Sorbonne Université, UPMC, Paris, France
| | - Mehdi Touat
- Sorbonne Université, UPMC, Paris, France; Inserm U1127, CNRS UMR 7225, Institut du cerveau, ICM, France; Service de Neuro-oncologie, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, APHP, Paris, France
| | - Alexandre Carpentier
- Service de Neurochirurgie, Hôpitaux universitaires La Pitié Salpêtrière - Charles Foix, APHP, Paris, France; Sorbonne Université, UPMC, Paris, France
| | - Etienne Lefevre
- Service de Neurochirurgie, Hôpitaux universitaires La Pitié Salpêtrière - Charles Foix, APHP, Paris, France; Sorbonne Université, UPMC, Paris, France.
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Khaboushan AS, Ohadi MAD, Amani H, Dashtkoohi M, Iranmehr A, Sheehan JP. Stereotactic radiosurgery for intraventricular meningioma: a systematic review and meta-analysis. Acta Neurochir (Wien) 2024; 166:286. [PMID: 38980438 PMCID: PMC11233396 DOI: 10.1007/s00701-024-06185-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/01/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Intraventricular meningioma (IVM) is a rare subtype of intracranial meningioma, accounting for 9.8 to 14% of all intraventricular tumors. Currently, there is no clear consensus on which patients with IVM should receive conservative treatment, surgery, or stereotactic radiosurgery (SRS). This research aims to analyze the outcomes, including survival and recurrence rates of patients who undergo SRS for IVM as a primary or adjuvant treatment. METHODS A systematic search was conducted in Scopus, Web of Science, PubMed, and Embase till June 5th 2023. Screening and data extraction were performed by two independent authors. Random-effect meta-analysis was performed to determine the tumor control proportion of IVM cases treated with SRS. Individual patient data (IPD) meta-analysis was performed for the progression-free survival (PFS) of the patients in the follow-up time. All analyses were performed using the R programming language. RESULTS Out of the overall 132 records, 14 were included in our study, of which only 7 had enough data for the meta-analysis. The tumor control proportion was 0.92 (95% CI, 0.69-0.98) in patients who underwent SRS for primary IVM. The overall tumor control in both primary and adjuvant cases was 0.87 (95% CI, 0.34-0.99). the heterogeneity was not significant in both meta-analyses (P = 0.73 and P = 0.92, respectively). Post-SRS perifocal edema occurred in 16 out of 71 cases (0.16; 95% CI, 0.03-0.56), with no significant heterogeneity (P = 0.32). IPD meta-analysis showed a PFS of 94.70% in a 2-year follow-up. Log-rank test showed better PFS in primary SRS compared to adjuvant SRS (P < 0.01). CONCLUSIONS According to this study, patients with IVM can achieve high rates of tumor control with a low risk of complications when treated with SRS, regardless of whether they have received prior treatment. Although SRS could be a promising first-line treatment option for asymptomatic IVM, its efficacy in symptomatic patients and its comparison with resection require further investigation.
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Affiliation(s)
- Alireza Soltani Khaboushan
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Neurosurgery Department, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Dabbagh Ohadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neurosurgery Department, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh Amani
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Dashtkoohi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Neurosurgery Department, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran
| | - Arad Iranmehr
- Neurosurgery Department, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran
| | - Jason P Sheehan
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA.
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Ashir Shafique M, Saqlain Mustafa M, Haseeb A, Mussarat A, Arham Siddiq M, Faheem Iqbal M, Iqbal J, Kuruba V, Patel T. Trapped temporal horn: From theory to practice, a systematic review of current understanding and future perspectives. World Neurosurg X 2024; 23:100345. [PMID: 38511157 PMCID: PMC10950730 DOI: 10.1016/j.wnsx.2024.100345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/05/2023] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
Background The Entrapped Temporal Horn (ETH) is characterized by localized enlargement of the temporal horn of the lateral ventricle of the brain. This study aimed to investigate the factors, development, prognosis, and effective treatment. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic search was conducted in major research databases. The inclusion criteria included patients of all ages with TTH diagnosis in cohort studies, case series, and case reports. Results Our study included 160 patients and 49 studies. The major causes of TTH were neoplastic lesions (42.3%), infections (22.3%), and cystic disease (13.08%). Of these cases, 71 were unrelated to cranial surgery, while 89 were unrelated to prior surgeries. Headache was the most common symptom (41.91%), followed by seizures (13.20%), drowsiness (12.50%) and memory loss (11.00%). Surgery was not required in 17 patients. Fenestration of the trapped temporal horn was performed in 24 patients, while VP/VA shunt surgeries were performed in the majority (57 patients) owing to favorable outcomes, lower revision rates, and extensive experience. However, TTH recurred in six of the 21 patients who underwent endoscopic ventriculocisternostomy. Tumors were the main cause, and isolated headache was the most frequent symptom. Ventriculoperitoneal shunts (VPS) are preferred because of their positive outcomes, lower revision rates, and wider expertise. Tumors near the trigonal area pose a higher risk. Conclusion Although TTH remains a rare condition, VPS continues to be the most widely preferred procedure among surgeons.
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Affiliation(s)
| | | | - Abdul Haseeb
- Department of Neurosurgery, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Abdullah Mussarat
- Department of Neurosurgery, Jinnah Sindh Medical University, Karachi, Pakistan
| | | | | | - Javed Iqbal
- King Edward Medical University, Lahore, Pakistan
| | | | - Tirath Patel
- American University of Antigua College of Medicine, Antigua and Barbuda
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Lin Z, Liao D, Zheng D, Lin F, Lin Y, Jiang Z, Ren X, Lin S. Comparison of temporal-to-frontal horn shunt and ventriculo-peritoneal shunt for treatment of trapped temporal horn: a retrospective cohort study. Neurosurg Rev 2023; 46:77. [PMID: 36971891 DOI: 10.1007/s10143-023-01981-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023]
Abstract
As a localized hydrocephalus, trapped temporal horn (TTH) can be effectively resolved via cerebrospinal fluid shunting. In addition to conventional ventriculo-peritoneal shunt (VPS), temporal-to-frontal horn shunt (TFHS) has been described as a less complex and invasive procedure with promising results; however, there is limited data comparing VPS to TFHS regarding patient outcomes. This study aims to compare TFHS versus VPS for treatment of TTH. We conducted a comparative cohort study with patients undergoing TFHS or VPS for TTH after surgery of trigonal or peritrigonal tumors between 2012 and 2021. The primary outcome was revision rates at 30-day, 6-month, and 1-year. Secondary outcomes included operative duration, postoperative pain, hospital stay, overdrainage, and cost for shunt placement and revision. A total of 24 patients included, with 13 (54.2%) patients receiving TFHS and 11 (45.8%) receiving VPS. Both cohorts shared similar baseline characteristics. There were no significant differences between TFHS and VPS in 30-day (7.7% vs 9.1%, p > 0.99), 6-month (7.7% vs 18.2%, p = 0.576), or 1-year (8.3% vs 18.2%, p = 0.590) revision rates. There were no significant differences in terms of operative duration (93.5 ± 24.1 vs 90.5 ± 29.6 min, p = 0.744), surgical site pain (0 vs 18.2%, p = 0.199), or postoperative length of stay (4.8 ± 2.6 vs 6.9 ± 4.0 days, p = 0.157) between the two groups. For the TFHS cohort, no patient experienced shunt related overdrainage, and there was a trend towards fewer overdrainage (0% vs 27.3%, p = 0.082) compared with VPS. TFHS offered significant reduction in cost for initial shunt (¥20,417 vs ¥33,314, p = 0.030) and total costs for shunt and revision (¥21,602 vs ¥43,196, p = 0.006) compared to VPS. As a technique of valveless shunt and without abdominal incision, TFHS is cosmetic, cost-effective, and completely free of overdrainage with similar revision rates as compared with VPS.
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Affiliation(s)
- Zhiqin Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Road of the South 4th Ring, No. 119, Fengtai District, Beijing, 100160, China
- Department of Neurosurgery, Radiotherapy, Longyan First Affiliated Hospital of Fujian Medical University, Fujian, China
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Dongxia Liao
- Department of Neurosurgery, Radiotherapy, Longyan First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Dao Zheng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Road of the South 4th Ring, No. 119, Fengtai District, Beijing, 100160, China
| | - Fuxin Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yuanxiang Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Zhongli Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Road of the South 4th Ring, No. 119, Fengtai District, Beijing, 100160, China
| | - Xiaohui Ren
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Road of the South 4th Ring, No. 119, Fengtai District, Beijing, 100160, China.
| | - Song Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Road of the South 4th Ring, No. 119, Fengtai District, Beijing, 100160, China
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Christ SM, Farhadi DS, Junzhao S, Mahadevan A, Thormann M, Lam FC, Yu X, Kasper EM. Efficacy and Safety of Primary Stereotactic Radiosurgery in Patients With Intraventricular Meningiomas. Adv Radiat Oncol 2023; 8:101098. [PMID: 36407683 PMCID: PMC9666502 DOI: 10.1016/j.adro.2022.101098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose Primary stereotactic radiosurgery for intraventricular meningiomas remains controversial owing to the potential for life-threatening peritumoral edema and lack of long-term follow-up data. We review the literature and present the largest series to assess efficacy and safety of primary stereotactic radiosurgery. Methods and Materials A systematic review of the literature for primary stereotactic radiosurgery for intraventricular meningiomas was conducted. The retrospective series presented here comprised 33 patients who received primary stereotactic radiosurgery between 1999 and 2015 for a radiologically detected intraventricular meningioma. Demographic, diagnostic, and therapeutic data were extracted from medical records, imaging, and treatment-planning systems. Both standalone and pooled analysis were performed. Results The mean patient age was 53 years, and 24 patients (73%) were female. The median Karnofsky performance status pretreatment was 80 (range, 60-100). The majority of lesions were located in the lateral ventricles (n = 32; 97%). The mean tumor volume was 8.7 cm3 (range, 0.6-44.55 cm3). The mean delivered dose was 1390.9 cGy. Complete imaging follow-up data were available for 21 patients (64%). Of those, 14 (67%) showed partial or marginal response, 7 (33%) had stable disease, and no patient progressed per Response Assessment in Neuro-Oncology criteria. On last follow-up, 32 patients (97%) had significant improvement in performance status and a decrease in pretreatment symptoms. No high-grade Common Terminology Criteria for Adverse Events (version 5.0) toxicity was observed with the dose range employed. Conclusions Primary stereotactic radiosurgery for intraventricular meningiomas shows excellent treatment efficacy and low toxicity in patients with a long follow-up period. The best therapeutic algorithm remains to be established leveraging further clinical investigation.
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Ren X, Cui Y, Yang C, Jiang Z, Lin S, Lin Z. Refined Temporal-to-Frontal Horn Shunt for Treatment of Trapped Temporal Horn After Surgery of Peri- or Intraventricular Tumor: A Case Series Study. Front Oncol 2021; 11:781396. [PMID: 34900736 PMCID: PMC8657764 DOI: 10.3389/fonc.2021.781396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background Trapped temporal horn (TTH) is a localized hydrocephalus that can be treated with cerebrospinal fluid diversion. Refined temporal-to-frontal horn shunt (RTFHS) through the parieto-occipital approach is rarely reported in the literature and its effectiveness remains unclear. The aim of the present study is to investigate the efficacy and outcome of RTFHS for treatment of TTH. Materials and Methods We consecutively enrolled 10 patients who underwent RTFHS for TTH after surgical resection of peri- or intraventricular tumors from February 2018 to March 2021. Clinical, radiological, and follow-up data were collected and analyzed. The most common underlying pathology was meningioma (n=4), followed by central neurocytoma (n=3), thalamic glioblastoma (n=2), and anaplastic ependymoma (n=1). Results The mean Karnofsky performance scale (KPS) score and TTH volume at onset were 54.0 ± 15.1 (range 40-80) and 71.3 ± 33.2cm3 (range 31.7-118.6cm3), respectively. All patients (10/10, 100.0%) presented with periventricular brain edema (PVBE), while midline shift was observed in 9 patients (9/10, 90.0%). RTFHSs were implanted using valveless shunting catheters. No patients developed acute intracranial hemorrhage or new neurological deficit postoperatively. During the follow-up of 17.2 ± 13.7 months (range 3-39 months), all patients showed clinical and radiological improvement. The mean KPS score at the last follow-up was significantly increased to 88.0 ± 10.3 (range 70-100, p<0.0001). RTFHS resulted in significant complete remission in PVBE and midline shift in 8 (80.0%, p=0.0007) and 9 (100.0%, p=0.0001) patients, respectively. As the postoperative follow-up duration prolonged, the mean TTH volume decreased in a consistent, linear trend (p<0.0001). At last follow-up, the mean TTH volume was significantly reduced to 15.4 ± 11.5 cm3 (range 5.6-44.1 cm3, p=0.0003), resulting in a mean relative reduction of 77.2 ± 13.1% compared with the volume of TTH at onset. Over drainage was not observed during the follow-up. No patient suffered from proximal or distal shunt obstruction or shunt related infection, and the revision rate was 0%. Conclusion RTFHS seems to be safe and effective for the treatment of TTH with favorable outcomes. Advantages of this technique could be technically less complex and invasive, cost-effective, avoidance of various intraperitoneal complications, and maintaining a near-physiological CSF pathway.
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Affiliation(s)
- Xiaohui Ren
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yong Cui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chuanwei Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhongli Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Song Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Zhiqin Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Fujian, China
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Chen CC, Freeman D, Warnke PC. Stereotactic and endoscopic treatment of the trapped temporal horn. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2020.101053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Giugliano M, Scafa AK, Chiarella V, Di Bartolomeo A, Bruzzaniti P, D'Andrea G, Salvati M, Santoro A. Entrapment of the temporal horn: case series and systematic review of literature. J Neurosurg Sci 2020; 65:532-540. [PMID: 33297607 DOI: 10.23736/s0390-5616.20.05111-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Entrapment of the temporal horn (ETH) is a form of focal, obstructive hydrocephalus. Etiology and clinical presentation are diversified. Though known since 1947, standard treatment has not yet been defined. The objective of our study was to perform a systematic review on ETH. Data from patients treated at our Institution from 2008 to 2019 were retrospectively collected and analyzed. A systematic PRISMA review of literature was also performed using PubMed and Google Scholar. 121 cases (mean age 41 years; M/F ratio 1/1) were analyzed. In 65 (vs 56) cases (53.7% vs 46.3%) ETH was not surgery related. Headache was the most common symptom (42%). "Major" treatments were (1) ventriculoperitoneal/ventriculoatrial shunt (42 cases, 34.7%), and (2) endoscopic ventriculocisternostomy (12 cases, 9.9%). In the first group, no perioperative complications were found, 39 patients (92.9%) had a favorable outcome, 3 patients (7.1%) died for the underlying disease, 4 cases (9.5%) went through revision; also considering the cases in which another procedure was performed as definitive treatment, shunt failures were 6 (13.6%). In the second group, 1 case (8.3%) developed a deep intracerebral hemorrhage, 11 cases (91.6%) had a favorable long-term outcome, 1 case (8.3%) had a favorable short-term outcome; also considering the cases in which another procedure was performed as definitive treatment, endoscopic ventriculocisternostomy failures were 6 (37.5%). Described as uncommon, ETH is probably underestimated. Early diagnosis and appropriate treatment are critical. VP shunt is still the most commonly performed treatment. Further randomized clinical trials are, however, needed to establish the gold standard.
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Affiliation(s)
- Marco Giugliano
- Department of Neurological Sciences, Neurosurgery, La Sapienza University of Rome, Rome, Italy
| | - Anthony K Scafa
- Department of Neurological Sciences, Neurosurgery, La Sapienza University of Rome, Rome, Italy -
| | - Vito Chiarella
- Department of Neurological Sciences, Neurosurgery, La Sapienza University of Rome, Rome, Italy
| | | | - Placido Bruzzaniti
- Department of Neurological Sciences, Neurosurgery, La Sapienza University of Rome, Rome, Italy
| | - Giancarlo D'Andrea
- Department of Neurosurgery, Fabrizio Spaziani Hospital, Frosinone, Italy
| | - Maurizio Salvati
- Department of Neurological Sciences, Neurosurgery, La Sapienza University of Rome, Rome, Italy
| | - Antonio Santoro
- Department of Neurological Sciences, Neurosurgery, La Sapienza University of Rome, Rome, Italy
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Lin Z, Zhang X, Shen S, Gao Z, Guan C, Liu T, Guo D, Qi X, Ren X, Jiang Z. Postoperative delayed trapped temporal horn in patients with lateral ventricular trigone meningioma: Risk factors, surgical management, and literature review. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2020; 46:2324-2330. [PMID: 32371042 DOI: 10.1016/j.ejso.2020.04.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/15/2020] [Accepted: 04/16/2020] [Indexed: 02/09/2023]
Abstract
OBJECT To assess the risk factors for and surgical treatment of delayed trapped temporal horn (dTTH) in patients who had undergone removal of lateral ventricular trigone meningioma. METHOD Patients with lateral ventricular trigone meningioma treated at our institution from 2011 to 2015 were identified. Predictors for dTTH were determined using logistic regression. Literature review and pooled analysis were also conducted to evaluate the comparative effectiveness of surgical treatment for dTTH. RESULTS A total of 110 cases were included in the analysis. Thirteen (11.8%) cases developed dTTH following surgery. Multivariable logistic regression demonstrated an association of longer operative duration with higher incidence of dTTH (OR, 1.34; 95% CI, 1.00-1.80; p = 0.049). As surgical duration prolonged from less than 3 hours to 5 hours or more, the incidence of dTTH increased in a consistent, linear fashion from 7.7% to 13.9% (p = 0.03). Six cases (46.2%, 6/13) of dTTH underwent surgical treatment for their life-threatening symptoms. Seven studies including 13 cases of dTTH in the literature were identified. Literature data, including the current series, revealed a total of 24 procedures were performed in 19 cases. Endoscopic fenestration trended toward fewer complications than shunt (7.7% vs 25.0%, p = 0.530). There were no significant differences in failure rates between the two groups (23.1% vs 25.0%, p = 1.000). CONCLUSION Patients with prolonged operative duration may be at higher risk of dTTH. Endoscopic fenestration is considered in preference to shunt placement, since it possesses equivalent success rates with fewer complications and avoids the need for a permanent implant.
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Affiliation(s)
- Zhiqin Lin
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Xiaohui Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shaoshan Shen
- Department of Neurosurgery, Zhangzhou Hospital, Fujian Medical University, Fujian, China
| | - Zhenwen Gao
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Celin Guan
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Tianqing Liu
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Dongbin Guo
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Xiaolong Qi
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Xiaohui Ren
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhongli Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Frame-Based Stereotactic Endoscopic Third Ventriculostomy-Toward Improved Precision and Minimizing Morbidities. World Neurosurg 2020; 140:e240-e246. [PMID: 32437981 DOI: 10.1016/j.wneu.2020.05.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/30/2020] [Accepted: 05/02/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Endoscopic third ventriculostomy (ETV) is a widely accepted treatment for obstructive hydrocephalus. For most practitioners, this procedure will be performed without navigation guidance. Without such guidance, the complications associated with the procedure have ranged from 1% to 8%. We hypothesized that the discrepancy between the surface bony anatomy and internal cranial anatomy contributes to the morbidities associated with ETV. We tested this hypothesis by comparing the position of the entry point defined by the classic Kocher's point relative to the ideal entry point that would result in no manipulation of the endoscope defined by frame-based stereotaxis. METHODS The cranial computed tomography scan of 58 patients who had undergone frame-based stereotactic ETV was reformatted into 3-dimensional renderings. The location of this entry point was compared with the Kocher point, as determined by the external bony anatomy. RESULTS Overall, >70% of the burr holes that provided an ideal trajectory to the third ventricle were ≥0.5 cm from the Kocher point in both the sagittal and the coronal planes. Median deviations of 0.74 and 0.81 cm in the coronal (P < 0.01) and sagittal (P < 0.0001) planes were observed. CONCLUSION The use of stereotactic endoscopic techniques increase the safety of third ventriculostomy by adding precision and reducing otherwise unnecessary surgical maneuvering.
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Lin Z, Wang C, Gao Z, Li X, Lan F, Liu T, Wang Y, Jiang Z. Clinical characteristics of and treatment protocol for trapped temporal horn following resection of lateral ventricular trigone meningioma: a single-center experience. J Neurosurg 2020; 132:481-490. [PMID: 30771768 DOI: 10.3171/2018.11.jns182710] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/02/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Trapped temporal horn (TTH) is a rare subtype of loculated hydrocephalus that is often managed surgically. The natural history of TTH is not well understood, and there are few data on the outcomes of conservative management of this condition. The aim of this study was to analyze the clinical features and outcomes of conservatively and surgically managed cases of TTH. METHODS The authors retrospectively reviewed the clinical data for 19 consecutive cases of TTH that developed after microsurgical resection of lateral ventricular trigone meningioma between 2011 and 2015. RESULTS The 19 cases involved 6 male and 13 female patients (mean age [± SD] 39.9 ± 13.8 years). The mean time interval from tumor resection to onset of TTH was 3.2 ± 3.0 months (range 3 days-10 months). Symptoms of intracranial hypertension were the most common complaints at presentation. The mean Karnofsky Performance Scale (KPS) score at onset was 52.1 ± 33.3 (range 10-90). Midline shift was observed in 15 cases (78.9%), and the mean amount of midline shift was 6.0 ± 4.8 mm (range 0-15 mm). Eleven cases (57.9%) were managed with surgical intervention, while 8 cases (42.1%) were managed conservatively. All patients (100%) showed improved clinical status over the course of 4.8 ± 1.0 years (range 2.8-6.3 years) of follow-up. The mean KPS score at last follow-up was 87.9 ± 11.3 (range 60-100). Eighteen patients (94.7%) showed signs of radiographic improvement, and 1 patient (5.3%) exhibited stable size of the temporal horn. Significant differences were observed between the surgical and nonsurgical cohorts for the following variables: KPS score at onset, presence of intracranial hypertension, and midline shift. The mean KPS score at onset was greater (better) in the nonsurgical group than in the surgical group (82.5 ± 8.9 vs 30 ± 25.7, p = 0.001). A greater proportion of patients in the surgical group presented with symptoms of intracranial hypertension (81.8% vs 0%, p = 0.001). The extent of midline shift was greater in the surgical group than in the nonsurgical group (9.0 ± 3.8 mm vs 2.0 ± 2.4 mm, p = 0.001). CONCLUSIONS The majority of patients with TTH presented in a delayed fashion. TTH is not always a surgical entity. Spontaneous resolution of TTH may be under-reported. Conservative management with clinical and radiological follow-up is effective in selected patients.
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Affiliation(s)
- Zhiqin Lin
- 2Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Chengjun Wang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Zhenwen Gao
- 2Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Xiangrong Li
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Folin Lan
- 2Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Tianqing Liu
- 2Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Yongzhi Wang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
| | - Zhongli Jiang
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; and
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Liu J, Long SR, Li GY. Entrapment of the temporal horn secondary to postoperative gamma-knife radiosurgery in intraventricular meningioma: A case report. World J Clin Cases 2019; 7:2894-2898. [PMID: 31616708 PMCID: PMC6789398 DOI: 10.12998/wjcc.v7.i18.2894] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/23/2019] [Accepted: 07/27/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Entrapment of the temporal horn (ETH) is a rare pathologic condition. It is a kind of focal hydrocephalus caused by obstruction of flow pathway of cerebrospinal fluid. It is caused by various conditions, but ETH secondary to postoperative gamma-knife radiosurgery (GKS) is extremely rare.
CASE SUMMARY A 52-year old previously healthy woman underwent resection of a large intraventricular meningioma. A small fragment of residual tumor with no obvious enlargement of the temporal horn was observed 3 mo after surgery, and she was referred for GKS. Two months after GKS, she complained of headache and progressive paralysis of the left limb. Magnetic resonance imaging revealed enlargement of the temporal horn. There was a second procedure to resect the residual tumor 8 mo after GKS. After the second procedure, she recovered smoothly. As of the date of this writing, she has remained in good condition.
CONCLUSION This case reminds us that ETH should be considered in the treatment of intraventricular meningiomas, especially before GKS.
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Affiliation(s)
- Jia Liu
- Department of Neurosurgery, the First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Sheng-Rong Long
- Department of Neurosurgery, the First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Guang-Yu Li
- Department of Neurosurgery, the First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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Agrawal A, Moscote-Salazar LR, Huber Said PZ, Manchikanti V, Kumar VK, Kiran NS. Paradoxical Pupillary Dilation in a Case of Entrapped Temporal Horn of Lateral Ventricle with Evidence of Uncal Herniation on Imaging. World Neurosurg 2019. [DOI: 10.1016/j.wneu.2019.01.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lenski M, Biczok A, Tonn JC, Kreth FW. Stereotactic Internal Shunt Placement in Congenital Intracranial Cysts. World Neurosurg 2018; 123:e670-e677. [PMID: 30576829 DOI: 10.1016/j.wneu.2018.11.250] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/28/2018] [Accepted: 11/30/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Treatment of symptomatic intracranial cysts remains a controversial issue. We present a risk/benefit profile of a minimally invasive, not yet described, stereotactic internal shunt implantation technique. The provided data might serve as a reference against which other treatment modalities could be compared. METHODS From our prospective database, we identified a consecutive series of patients with symptomatic, untreated cysts who had undergone internal shunting from 2009 to 2017. We estimated the rates of clinical symptom improvement (RCSI), cyst reduction, total complications, and long-term complications. A minimal follow-up of 6 months was required. The prognostic factors were obtained from logistic regression models. Cyst recurrence-free survival was calculated using the Kaplan-Meier method. The outcomes data were compared with those from reported alternative treatment strategies using χ2 statistics. RESULTS We included 38 patients. The cyst locations differed greatly and included the cerebellum (n = 2), brainstem (n = 5), and pineal area (n = 4). Cyst-associated hydrocephalus (n = 6) resolved after treatment. The 2-year cyst recurrence-free survival rate was 97%. The RCSI and rate of cyst reduction, total complications, and long-term complications was 91%, 97%, 11%, and 2.6%, respectively. We did not find any risk factors associated with the rate of total complications. The RCSI and rate of total and long-term complications compared favorably (P < 0.01) with the corresponding estimates of alternative treatments (P < 0.01). CONCLUSIONS The described stereotactic internal shunt implantation technique is safe and can be successfully applied for treatment of cystic formations in any location in the brain.
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Affiliation(s)
- Markus Lenski
- Department of Neurosurgery, Klinikum der Universität München, Campus Großhadern, Munich, Germany.
| | - Annamaria Biczok
- Department of Neurosurgery, Klinikum der Universität München, Campus Großhadern, Munich, Germany
| | - Jörg-Christian Tonn
- Department of Neurosurgery, Klinikum der Universität München, Campus Großhadern, Munich, Germany
| | - Friedrich-Wilhelm Kreth
- Department of Neurosurgery, Klinikum der Universität München, Campus Großhadern, Munich, Germany
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Golpayegani M, Salari F, Anbarlouei M, Habibi Z, Nejat F. Huge bilateral temporal horn entrapment: a congenital abnormality and management. Childs Nerv Syst 2018; 34:2515-2518. [PMID: 30056473 DOI: 10.1007/s00381-018-3924-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/19/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Temporal horn entrapment is a rare disorder subsequent to obstruction around the trigone of the lateral ventricle caused by inflammations, tumors, infections, or after surgical processes. Most reports are unilateral and acquired but congenital ones have not been reported yet. METHODS Here we report the first congenital case of huge bilateral temporal horn entrapment. A six-month-old boy was admitted to our service with progressive intracranial hypertension who was managed with bilateral ventricular catheters and Y tube connected to one peritoneal catheter.
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Affiliation(s)
- Mehdi Golpayegani
- Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Salari
- Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mousarreza Anbarlouei
- Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Gharib street, Tehran, 141557854, Iran
| | - Zohreh Habibi
- Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Gharib street, Tehran, 141557854, Iran
| | - Farideh Nejat
- Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Gharib street, Tehran, 141557854, Iran.
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Arenas-Ruiz JA, Martinez-Maldonado H, Gonzalez-Carranza V, Torres-García S, Chico-Ponce de Leon F. Endoscopic ventriculo-cisterno-ventricular approach in the treatment of bilateral trapped temporal horn related to fungal infection in a child: case report and review of the literature. Childs Nerv Syst 2018; 34:1593-1597. [PMID: 29557511 DOI: 10.1007/s00381-018-3776-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/08/2018] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Focal hydrocephalus including trapped temporal horn (TTH), isolated lateral and fourth ventricles, is caused by obstruction and/or adhesion related to various etiologies. With the advent of the neuroendoscope, endoscopic procedures have become an alternative in selected cases. CASE REPORT A 2-year-old male from a rural town in México was referred to our institution because of multiple supra- and infra-tentorial abscesses and hydrocephalus. The patient had progressive deterioration and developed bilateral trapped temporal horn related to multi-septated hydrocephalus, so we performed an endoscopic ventricular-cistern-ventriculostomy through a single right temporal burr hole. POSTOPERATIVE COURSE Bilateral TTH and multi-septated hydrocephalus were effectively treated with a single external ventricular drainage (EVD) catheter, from the right temporal horn to the left temporal horn through the interpeduncular cistern; after clamping the EVD for 3 days with no evidence of hydrocephalus, the EVD was removed. The size of the ventricles remained stable afterwards, and no clinical or radiological evidence of hydrocephalus was observed after 3 months of follow-up. DISCUSSION Endoscopic ventriculocisternostomy is effective in selected cases of TTH. We know that dilatation of the temporal horn widens the window between the anterior choroidal artery and optic tract superiorly, and the posterior communicating and CN III inferiorly, making the described procedure feasible, even in the approach to the contralateral side. Even though this is a rare condition, we believe it is a safe and effective option to eliminate multiple shunts and/or to reduce the number of catheters needed to treat bilateral THH related to multi-septated hydrocephalus.
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Affiliation(s)
- José Ascención Arenas-Ruiz
- Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Cuauhtémoc, 06720, Ciudad de México, CDMX, Mexico
| | - Horus Martinez-Maldonado
- Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Cuauhtémoc, 06720, Ciudad de México, CDMX, Mexico
| | - Vicente Gonzalez-Carranza
- Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Cuauhtémoc, 06720, Ciudad de México, CDMX, Mexico
| | - Samuel Torres-García
- Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Cuauhtémoc, 06720, Ciudad de México, CDMX, Mexico
| | - Fernando Chico-Ponce de Leon
- Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Cuauhtémoc, 06720, Ciudad de México, CDMX, Mexico.
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18
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Neuroendoscopic Fenestration for Entrapped Temporal Horn After Surgery: Report of 3 Cases. World Neurosurg 2018; 112:77-80. [DOI: 10.1016/j.wneu.2018.01.096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/11/2018] [Accepted: 01/12/2018] [Indexed: 01/17/2023]
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Paredes I, Orduna J, Fustero D, Salgado JAA, de Diego JMB, de Mesa FGLF. Endoscopic temporal ventriculocisternostomy for the management of temporal horn entrapment: report of 4 cases. J Neurosurg 2017; 126:298-303. [DOI: 10.3171/2016.1.jns152248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Entrapment of the temporal horn is a rare form of noncommunicating focal hydrocephalus. Standard treatment has not yet been established for this condition, and only a few cases have been reported in the literature. The authors reviewed their cases of temporal horn entrapment treated between May 2013 and December 2014 and report their experience with endoscopic temporal ventriculocisternostomy. Four patients were identified (3 adults and 1 child) who underwent this treatment. In 3 patients, the condition developed after tumor resection, and in 1 patient it developed after resection of an arteriovenous malformation. In 1 patient, a recurrent trapped temporal horn developed and a refenestration was successfully performed. No procedure-related complications were observed, and all of the patients remained shunt-free at last follow-up (range 4–24 months). Endoscopic temporal horn ventriculocisternostomy is a safe and effective procedure for the treatment of symptomatic temporal horn entrapment in selected cases. However, there is little experience with the procedure to recommend it as the treatment of choice.
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Affiliation(s)
- Igor Paredes
- 1Department of Neurosurgery, University Hospital 12 de Octubre, Madrid
| | - Javier Orduna
- 2Department of Neurosurgery, University Hospital Miguel Servet, Zaragoza; and
| | - David Fustero
- 2Department of Neurosurgery, University Hospital Miguel Servet, Zaragoza; and
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Wang Y, Lin Z, Li Z, Zhao M, Hu M, Zhang H, Chen X, Jiang Z. The Incidence and Risk Factors of Postoperative Entrapped Temporal Horn in Trigone Meningiomas. World Neurosurg 2016; 90:511-517. [PMID: 27012837 DOI: 10.1016/j.wneu.2016.03.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/13/2016] [Accepted: 03/14/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine risk factors for the occurrence of postoperative entrapped temporal horn (ETH), a specific form of isolated hydrocephalus that is a severe complication after resection of lateral ventricular trigone tumors, following trigone meningioma surgery. METHODS A retrospective review was performed of 121 cases of trigone meningiomas surgically treated between November 2011 and March 2015 in Beijing Tiantan Hospital. Patient demographics, imaging features, surgical procedures, and postoperative complications were evaluated by statistical analysis. RESULTS The median follow-up time was 24.1 months. Postoperative ETH developed in 23 patients (19.0%). Primary univariate analysis showed that young age, a longer clinical history, development of postoperative meningitis, and a longer duration of ventricular drainage were significantly associated with an increased risk of postoperative ETH. Subsequent multiple logistic regression analysis indicated that a clinical history of >3 months (odds ratio [OR], 4.8; P = 0.008), postoperative neurologic deficits (OR, 4.2; P = 0.014), duration of ventricular drainage >3 days (OR, 4.8; P = 0.012), and postoperative meningitis (OR, 9.9; P = 0.001) were independently associated with a risk of postoperative ETH. CONCLUSIONS Postoperative ETH frequently occurs in patients with trigone meningiomas. The severity of surgical injury of the surrounding brain tissue partly accounts for the risk of postoperative ETH. Clinical management of ventricular drainage and postoperative meningitis are of utmost importance. Ventricular drainage should be performed on an individual basis, and drainage tubes should be removed as early as possible.
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Affiliation(s)
- Yongzhi Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Zhiqin Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zongze Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Meng Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Mengqing Hu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hua Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaolin Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhongli Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Abderrahmen K, Gdoura Y, Kallel J, Jemel H. [Trapped temporal horn, an unusual form of obstructive hydrocephalus: 5 case-reports]. Neurochirurgie 2015; 62:108-12. [PMID: 26701318 DOI: 10.1016/j.neuchi.2015.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 09/02/2015] [Accepted: 09/23/2015] [Indexed: 01/17/2023]
Abstract
OBJECTIVE "Entrapped temporal horn" is an unusual form of obstructive hydrocephalus which is due to an obstacle at the trigone of the lateral ventricle that seals off the temporal horn that may act as a space occupying process. In this study, our aim was to assess the clinical presentation, imaging, pathophysiology and the management of this entity. METHODS The medical records of patients with entrapped temporal horn diagnosed between January 2003 and December 2012 were reviewed retrospectively. RESULTS Five patients were identified. In four cases, the condition developed after cranial surgery; an infant having two revisions of a ventriculoperitoneal shunt; an adult operated for a glioblastoma, an infant operated on for cerebral hydatidosis and an infant operated for an occipital encephalocele. In the last patient, the entrapped temporal horn revealed sarcoidosis. CONCLUSIONS Trapped temporal horn syndrome can act as a space occupying process and requires surgical management. Internal shunting provides good results. However, the long term outcome depends on the etiology.
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Affiliation(s)
- K Abderrahmen
- Service de neurochirurgie, Institut national de neurologie, faculté de médecine, université Tunis-Al Manar, rue Jebbari, 1007 Rabta, Tunis, Tunisie.
| | - Y Gdoura
- Service de neurochirurgie, Institut national de neurologie, faculté de médecine, université Tunis-Al Manar, rue Jebbari, 1007 Rabta, Tunis, Tunisie
| | - J Kallel
- Service de neurochirurgie, Institut national de neurologie, faculté de médecine, université Tunis-Al Manar, rue Jebbari, 1007 Rabta, Tunis, Tunisie
| | - H Jemel
- Service de neurochirurgie, Institut national de neurologie, faculté de médecine, université Tunis-Al Manar, rue Jebbari, 1007 Rabta, Tunis, Tunisie
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Hana T, Tanaka S, Shin M, Mukasa A, Kugasawa K, Saito N. Neuroendoscopic Ventriculocisternostomy with Stent Placement for Trapped Temporal Horn After the Resection of Glioblastoma. World Neurosurg 2015; 84:2078.e5-8. [DOI: 10.1016/j.wneu.2015.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/18/2015] [Accepted: 08/19/2015] [Indexed: 01/18/2023]
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Spallone A, Belvisi D, Marsili L. Entrapment of the Temporal Horn as a Cause of Pure Wernicke Aphasia: Case Report. J Neurol Surg Rep 2015; 76:e109-12. [PMID: 26251784 PMCID: PMC4520970 DOI: 10.1055/s-0035-1549225] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 01/13/2015] [Indexed: 01/21/2023] Open
Abstract
Entrapment of the temporal horn is an extremely rare pathologic condition occurring as a result of surgery for tumors, intraventricular infections, hemorrhage, or traumatic events involving the peritrigonal area. We report a case of a 58-year-old man who presented with pure Wernicke aphasia (never described before in the albeit rare cases of isolated temporal horn dilatation) that regressed completely following successful ventriculoperitoneal shunting. The relevant literature is also briefly reviewed.
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Affiliation(s)
- Aldo Spallone
- Section of Neurosurgery, Department of Clinical Neurosciences, Neurological Centre of Latium (NCL), Rome, Italy ; Department of Biomedicine, University of Rome "Tor Vergata," Rome, Italy
| | | | - Luca Marsili
- Section of Neurosurgery, Department of Clinical Neurosciences, Neurological Centre of Latium (NCL), Rome, Italy ; Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università, Rome, Italy
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Quenardelle V, Benmekhbi M, Aupy J, Dalvit C, Hirsch E, Benoilid A. Neurosarcoïdose de présentation atypique. Rev Med Interne 2013; 34:776-9. [DOI: 10.1016/j.revmed.2013.02.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 01/26/2013] [Accepted: 02/18/2013] [Indexed: 01/19/2023]
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