Fourth Ventricular Meningiomas

World Neurosurg. 2019 Jul:127:e1201-e1209. doi: 10.1016/j.wneu.2019.04.097. Epub 2019 Apr 17.


Objective: Fourth ventricular meningiomas (FVMs) are extremely rare. Here, we report a series of 11 patients at a single institution. A comprehensive literature analysis is conducted.

Methods: Information about 11 patient was extracted from the patient data. Reports of cases in English were obtained from the literature. Including our 11 patients, 71 patients were analyzed in this study.

Results: The most common age of onset was from the third decade to sixth decade of life. The female/male ratio was about 1.16:1. The most frequent subtype of meningioma was fibrous meningioma. FVMs had specific imaging features, such as calcification (20%), peritumoral edema (30.3%), heterogeneous enhancement (22.5%), cystic formation (4.3%), and hydrocephalus (52.8%). The proportion of total tumor resection was about 94.9%, with 15.3% of postoperative complications. During follow-up, the recurrent rate of FVMs was about 6.8%. There was no significant difference in the analysis of correlation between hydrocephalus and the maximum diameter of tumors, correlation between hydrocephalus and the volume of tumor, or correlation between peritumoral edema and the volume of tumor, as well as correlation between heterogeneous enhancement and the grade of meningiomas.

Conclusions: FVMs have their own characteristics in age of onset, gender ratio, histologic types, and imaging features. The recommended treatment is surgical treatment via the telovelar approach with suboccipital craniotomy/craniectomy. Adjuvant therapy is needed in some high-grade meningiomas and in patients undergoing partial resection. The prognosis is relatively good, with fewer postoperative complications and a higher rate of total resection.

Keywords: Clinical features; Fourth ventricle; Imaging features; Meningiomas; Treatment.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Fourth Ventricle / diagnostic imaging*
  • Fourth Ventricle / surgery*
  • Humans
  • Male
  • Meningeal Neoplasms / diagnostic imaging*
  • Meningeal Neoplasms / surgery*
  • Meningioma / diagnostic imaging*
  • Meningioma / surgery*
  • Middle Aged
  • Retrospective Studies