Abstract
Surgical approaches to lesions arising within the body of the lateral ventricle are divided into the transcortical middle frontal gyrus approach and the anterior interhemispheric transcallosal approach. Although the transcallosal route minimizes direct injury to the cerebral cortex, the surgical field is relatively limited because of the parasagittal bridging veins and restriction of the callosal incision. In our series of giant central neurocytomas occupying the entire body of the lateral ventricle, the resection rate was equal regardless if either the transcortical or transcallosal approach was used. Serious surgical complications of lateral ventricle tumors are deep venous infarction and memory disturbance due to fornix injury. In operative procedures for lateral ventricle tumors, it is important to identify the choroid plexus first, and then reach the foramen of Monro to confirm the thalamostriate vein and anterior septal vein. Injury to the fornix and thalamostriate veins can be avoided with early identification of these important anatomical landmarks. If the tumor is attached firmly to the fornix, strategy of subtotal removal combined with stereotactic radiation therapy would be appropriate for central neurocytomas because their radiosensitivity is relatively high.
