Background: Intraventricular tumors present significant surgical challenges due to their deep location and proximity to critical neuroanatomical structures. Surgical strategies include the transtemporal, interhemispheric and transparietal approaches, each carrying specific risks. Recently, a paramedian transparietal approach to a lateral ventricle meningioma in the dominant hemisphere was described. METHODS: We propose a mini-craniotomy, mixed reality-assisted paramedian transparietal approach via a trans-sulcal route for safe tumor resection while preserving critical white matter tracts.

Conclusions: This technique enhances the safety and efficacy of intraventricular tumor resection, particularly in young patients with dominant hemisphere lesions.