Abstract
We describe the various surgical approaches to the trigone of the lateral ventricle. There are four main approaches to those areas 1) a transcortical approach through the cerebral convexity, 2) a transcortical approach through the inferior surface of the temporal lobe, 3) an interhemispheric transcallosal or transcortical approach, and 4) a distal transsylvian approach. Many important structures such as the speech center area in the dominant cerebral hemisphere, visual pathways and high cognitive functions in the parieto-temporo-occipital lobes should be preserved during the surgical procedure. The high parietal lobe approach should be recommended in the dominant cerebral hemisphere. The stepwise procedures are demonstrated with a case of meningioma in the trigone of the left lateral ventricle. Knowledge of the microsurgical anatomy and an intraoperative neuronavigation system are helpful for safer and less invasive microsurgery.
