Integrated functional neuronavigation-guided resection of small meningiomas of the atrium via the paramedian parieto-occipital approach

• With the aid of the neuronavigation that incorporates fMRI and DTT results, small meningiomas located in the atrium of the lateral ventricle can be safely resected through the paramedian parieto-occipital approach.
• The neuronavigation that incorporates fMRI and DTT results can be helpful to the surgery.
• Small meningiomas located in the atrium of the lateral ventricle can be safely resected through the paramedian parieto-occipital approach.

ObjectiveSmall meningiomas located in the atrium of the lateral ventricle remain a challenge for neurosurgeons due to the eloquent nature of the surrounding anatomy. Functional MRI (fMRI) and diffusion tensor tractography (DTT) allow for in vivo demonstrations of eloquent cortical structures and neuronal fiber tracts, respectively. Our objective is to evaluate the contribution of functional neuronavigation combined with fMRI and DTT results to surgical outcomes.Materials and methodswe investigated 11 patients with small meningiomas located in the atrium of the lateral ventricle who underwent surgery with the aid of functional neuronavigation via the paramedian parieto-occipital approach. The patients willingly underwent assessments of neurologic deficits preoperatively and postoperatively at discharge and at three months after surgery.ResultsGross total resection was achieved in all patients, and no residual or recurrent tumors were observed on follow-up imaging. There was no mortality. Only one patient suffered from transient postoperative aphasia (mild to moderate) that was resolved one week after surgery. No novel neurologic deficits were present in any of the other patients, and no new-onset epileptic attacks were observed.ConclusionsWith the aid of the neuronavigation that incorporates fMRI and DTT results, small meningiomas located in the atrium of the lateral ventricle can be safely resected through the paramedian parieto-occipital approach.