Risk Factors For Postoperative Entrapped Temporal Horn In Trigone Meningiomas

Objective: Postoperative entrapped temporal horn(ETH)is a specific form of isolated hydrocephalus,which is a severe complication after resection of lateral ventricular trigone tumors.However,this has rarely been addressed in the literature.Therefore,the authors aimed to determine risk factors for the occurrence of postoperative ETH following trigone meningioma surgery.Methods: One hundred and twenty-one cases of trigone meningiomas surgically treated between November 2011 and March 2015 in Beijing Tiantan Hospital were retrospectively reviewed.The patients' demographics,imaging features,surgical procedures and postoperative complications were evaluated by statistical analysis.Results: The median follow-up was 24.1 months.A total of 23 patients(19.0%)developed postoperative ETH.The 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 neurological 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 trigone meningiomas.Traumatic ventricular wall and surrounding brain tissue partly account for the risk of postoperative ETH.Besides,clinical management of ventricular drainage and postoperative meningitis are of utmost importance.Ventricular drainage tube is not necessary for each trigone meningioma and should be performed on an individual basis.The duration of ventricular drainage should be kept at a minimum which contributes to minimizing postoperative ETH rates.