Adult intraventricular meningiomas in contemporary neurosurgical practice: a systematic review and meta-analysis.

BACKGROUND

Intraventricular meningiomas (IVMs) are rare adult tumors in deep-seated ventricular locations with challenging surgical anatomy and heterogeneous management. Contemporary pooled benchmarks for extent of resection, complications, and recurrence in adult intraventricular meningiomas remain limited.

METHODS

A systematic review and meta-analysis was performed following PRISMA 2020 and MOOSE guidelines. Studies published from 2019 to 2025 including adults with histologically confirmed IVMs were analyzed. Data on demographics, tumor location, histopathology, surgical management, and outcomes were extracted. Random-effects models pooled means and proportions; heterogeneity was assessed with I².

RESULTS

Thirty-four studies comprising 981 patients were included. Most tumors involved the lateral ventricles (83%), with a mean age of 48 years (95% CI, 45-51) and 63% female predominance. The pooled gross total resection (GTR) rate was 88% (95% CI, 82-93; I² = 52%), and the recurrence rate-in studies with ≥ 12 months follow-up-was 9% (95% CI, 4-19; I² = 0). Postoperative complications were reported descriptively across studies and consisted mainly of transient visual or motor deficits, hemorrhage, edema, and hydrocephalus requiring CSF diversion. Stereotactic radiosurgery achieved durable control for small residual or recurrent lesions. Among 297 tumors with available grading data, CNS WHO grade 1 tumors accounted for 74.1% and CNS WHO grade 2 tumors for 24.2%.

CONCLUSIONS

Adult IVMs are predominantly lateral-ventricle tumors affecting middle-aged women and are associated with generally favorable outcomes in specialized centers. Gross total resection remains the preferred goal when functionally feasible, whereas planned subtotal resection followed by early stereotactic radiosurgery may offer durable control in anatomically high-risk cases. These pooled benchmarks help contextualize current practice and highlight the need for improved molecular and neurofunctional reporting in future prospective studies.