Intraventricular cavernomas: Three cases and review of the literature

OBJECTIVE AND IMPORTANCE: Cavernomas occur very rarely in the ventricular s ystem. We report three cases of intraventricular cavernomas and review the literature. CLINICAL PRESENTATION: A 16-year-old female patient presented with a sudden distal deficit of the left superior limb. She had a voluminous tumor invol ving the two lateral ventricles, with radiological evidence of recent hemor rhage. A 30-year-old man presented with generalized seizures and a right he miplegia related to a 4-cm-diameter cavernoma in the two lateral ventricles involving the interhemispheric scissure through the corpus callosum and le ft centrum ovale. The radiological appearance was not typical and did not a llow the diagnosis. A 42-year-old man had a cavernoma in the third ventricl e, which was responsible for his short-term memory loss. This cavernoma had been revealed by computed tomography that was performed after intracerebra l hemorrhage related to another cavernoma in the right parietal lobe occurr ed. INTERVENTION: Stereotactic biopsies allowed the diagnosis of intraventricul ar cavernoma in the first case. Surgical removal via a right transcortical transventricular approach and a transcallosal approach in the first and sec ond cases, respectively, was complete, resulting in good outcomes. Surgical removal via a right transcortical transventricular approach in the third c ase was partial. CONCLUSION: Intraventricular cavernomas are so uncommon that only 42 well-d ocumented cases have been previously reported in the literature. It seems t hat their radiological diagnosis may be difficult because of their uncommon location in the ventricular system and their voluminous size. A wrong preo perative diagnosis has sometimes been the cause of inefficient therapy, suc h as radiotherapy, for these surgically curable benign lesions.