Complications avoidance in transcortical approach to lateral ventricle tumors: Analysis of 38 cases

Elhabashy, Abdelrahman Magdy; Agamy, Mohammed M; Sorour, Islam; Fayed, Ahmed Abd Aziz

doi:10.21608/pajn.2024.279592.1123

Complications avoidance in transcortical approach to lateral ventricle tumors: Analysis of 38 cases

Document Type : Original Articles

Authors

¹ Department of Neurosurgery, Alexandria University

² Neurosurgery department, Faculty of medicine, Alexandria University, Egypt

³ department of neurosurgery, Alexandria university, Egypt

10.21608/pajn.2024.279592.1123

Abstract

Background: Lateral ventricle tumors could be approached through different corridors. Accurate selection of the surgical approach coupled with avoiding or minimizing the expected complications improves the surgical outcome.
Aim: To analyze complications related to transcortical approach to lateral ventricle tumors. Moreover, to explain the causes behind these complications and their management.
Methods: prospective study presenting outcome as well as complications of 38 patients with tumors of lateral ventricle, operated by transcortical approach. Clinical and imaging follow up were performed in all patients at 0, 3, 6 and 12 months.
Results: Enrolled patients included 25 male and 13 female patients, operated by transcortical approach. The mean age was 30 years (ranging from 2 to 65 years). Duration of symptoms ranged from 15 days to 6 months. The initial postoperative evaluation disclosed 31% of patients with some neurological improvement and no direct post-operative surgical mortality. Gross total resection was achieved in 30 patients (78.9%).
Complications related to cortical incisions were mental changes in 5 patients that underwent frontal cortical incisions (left> right) and field defect in a single patient that underwent temporal cortical incision. Most common complications were intraventricular (IV) hemorrhage in 4 patients, postoperative seizures in 4 patients and acute hydrocephalus in 10 patients that needed post-resection shunts. Clinical follow-up at 12 months revealed good recovery in 31 patients (81%).
Conclusion: Proper patient preparation with appropriate selection of the cortical corridor and proper surgical techniques can decrease or even prevent the different complications encountered.

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