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In order to study the clinical characteristics of intraventricular meningiomas, we analyzed retrospectively 25 patients and reviewed the literature with regard to incidence, clinical manifestation, imaging features, preoperative diagnosis, surgical findings, and histopathological results. Intraventricular meningiomas are quite rare, but they represent an important differential diagnosis of intraventricular neoplasms. Computed tomography or magnetic resonance imaging enable a correct diagnosis of intraventricular meningiomas in most of the cases. The tumors often grow slowly to a substantial size before they become symptomatic. The operative route should be selected according to the tumor's location. Out of the 24 lateral ventricular meningiomas in our series, 20 were resected via a posterior parieto-occipital transcortical approach, two were resected via a transcallosal approach, and another two tumors, located in the frontal horn and body of the lateral ventricle, were resected via a frontal approach. A median suboccipital craniotomy was performed for the fourth ventricular meningioma. The parieto-occipital route for lateral ventricular meningiomas is a safe surgical approach, which is not necessarily associated with postoperative visual deficits. Piecemeal removal of the tumor can be safely and easily performed and special attention should be paid to the choroidal vessels intraoperatively.

Arteriovenous fistulae of the superficial temporal artery are rare, and their principal cause is traumas. Complications include pulsatile mass, headache, hemorrhage and deformities that compromise esthetics. Treatment can be performed using conventional surgery or endovascular methods. The authors describe a case of a 44-year-old male patient who developed a large pulsating mass, extending from the preauricular region to the right parietotemporal and frontal regions after a motorcycle accident. The treatment chosen was complete surgical removal of the pulsatile mass and ligature of the vessels feeding the fistula.Keywords: arteriovenous fistulae; superficial temporal artery; trauma. ResumoAs fístulas arteriovenosas de artéria temporal superficial são raras, sendo o trauma sua etiologia principal. Suas complicações incluem massa pulsátil, cefaleia, hemorragia e deformidade estética. O tratamento pode ser realizado por cirurgia convencional ou endovascular. Os autores relatam o caso de um paciente de 44 anos que evoluiu com massa pulsátil extensa desde região pré-auricular até região parietotemporal e frontal direita após acidente motociclístico. Optou-se por remoção cirúrgica completa da massa pulsátil e ligadura dos vasos nutridores da fístula.Palavras-chave: fístula arteriovenosa; artéria temporal superficial; trauma.

Objective: To study the clinical characteristics and treatment of meningiomas in children. Methods: One hundred and sixty-six meningiomas in children, including 12 cases treated in Qilu hospital and 8 series reported in the literature, were analyzed retrospectively on sex, age distribution, presenting symptoms, signs, radiological and pathological findings, treatment and prognosis. Results: The ratio of boys and girls was 2.3:1. The age ranged from 0.5 to 15 years (mean 9.9 years). Cranial nerve disorder (28%) and signs of chronic increased intracranial pressure such as headaches (62%), vomiting (53%) and papilledema (55%) were the most common symptoms. The most common location was the cerebral convexity (41%), followed by ventricles (15%), saddle areas (8%), cerebellopontine angles (8%), brain intraparenchyma (5%), parasagittal regions (4%), etc. Homogeneous density was observed in 62.3% of all cases, calcification in 14.8%, cystic components in 21.3% and intratumoral hemorrhage in 1.6%. On average, the epithelial and fibroblastic types of meningiomas took up 55% of the case, while the amount of malignant or atypical meningiomas averaged 9%. Complete tumor excision was achieved in 74%, and postoperative mortality was 3.3%. Conclusions: Compared with meningiomas in adults, meningiomas in children occur predominantly in males with a lower incidence rate of epilepsy, and are frequently associated with multiple neurofibromatosis. Meningiomas in children have a poorer prognosis than those in adults. Degree of the first tumor resection, tumor location, pathological grade and association with neurofibromatosis are the most important factors influencing the patients’ prognoses.

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