The paramedian supracerebellar transtentorial approach to the posterior fusiform gyrus

Chau, Anthony; Gagliardi, Filippo; Smith, Adam; Pelzer, Nicholas Robert; Stewart, Fiona; Mortini, Pietro; Elbabaa, Samer K.; Caputy, Anthony J.; Gragnaniello, Cristian

doi:10.1007/s00701-016-2960-8

Cited by 6 publications

(2 citation statements)

References 15 publications

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“…Their conclusions highlight that SCTT is the approach with the greatest maneuverability area and broadness and the lowest working depth. [ 1 ] The main limitation of SCTT is the possibility of venous infarction due to coagulation of bridging veins and their anatomical margins.…”

Section: Discussionmentioning

confidence: 99%

Supracerebellar transtentorial approach for left parahippocampal cavernous malformation

López

Herbera

Sufuentes

et al. 2021

Surgical Neurology International

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Background: Lesions in the temporomesial region can be reached by various approaches: subtemporal, transsylvian, transcortical, interhemispheric parieto-occipital, or supracerebellar transtentorial (SCTT). The choice varies according to the characteristics of the lesion and neighboring structures. Case Description: In this clinical case, it is presented a 56-year-old man with long-term evolution of drug-resistant epilepsy secondary to a cavernoma in the left parahippocampal gyrus. After assessing the lesion, it was decided a SCTT approach for its resection in a semi-sitting position, to avoid language disorders or visual damage. The surgery was uneventful and the patient did not present epileptic seizures during 6-month follow-up. Conclusion: Performing a SCTT is safe and feasible option for resection of lesions located in the basal temporomesial region without causing damage to neighboring structures, especially those located in the middle and posterior two-thirds of temporal region.

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Section: Discussionmentioning

confidence: 99%

Supracerebellar transtentorial approach for left parahippocampal cavernous malformation

López

Herbera

Sufuentes

et al. 2021

Surgical Neurology International

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“…As described in one of our previously published report, 29 the operability score (OS) represents a brand new tool for quantitative assessment of surgical operability. 17,[30][31][32][33][34][35] It provides a grading system based on four variables corresponding to the above-mentioned depth of the surgical field, the maneuverability area, the maneuverability arc, and the surgical angle of attack. The maneuverability area is defined as the cross-section surface of the surgical corridor.…”

Section: Assessment Of Operabilitymentioning

confidence: 99%

Endoscope-Assisted Neuroportal Transcerebellar Approach to the Fourth Ventricle: An Anatomical Study

Piloni

Gagliardi

Bailo

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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Background and Study Aims Minimally invasive approaches to deep-seated lesions still represent a fundamental issue in modern neurosurgery. Tubular retractors allow to enhance the operability of intraventricular lesions, minimizing the risk of damages to brain parenchyma. Increasing interest for portal devices has been mainly focused on supratentorial pathologies, while transportal approaches in the posterior cranial fossa have been rarely described. In the present study, the authors aimed to investigate the surgical exposure and operability obtained with a microsurgical neuroportal transcerebellar approach targeting the fourth ventricle, assisted by endoscopic exploration. Material and Methods Six cadaveric specimens were provided for anatomical microsurgical dissection and Vycor ViewSite Brain Access System was used as tubular retractor. Surgical feasibility of the neuroportal transcerebellar approach was demonstrated through a definable and measurable parameter, the operability score. Results The neuroport provided a surgical corridor away from eloquent structures to target the whole fourth ventricle cavity, preventing injury to cerebellar nuclei and white matter pathways and, potentially, minimizing the risk of surgical morbidity. Maximal operability was reached in the pontomedullary junction and medullary area of the ventricular floor. Transportal endoscopic assistance contributed to a further extension of surgical exposure in blind spots, corresponding to the ipsilateral lateral recess, the uppermost part of the fourth ventricle, and the obex. Conclusion The neuroportal transcerebellar approach represents a viable alternative route to the fourth ventricle, avoiding vermian splitting or subarachnoid dissection of the cerebellomedullary cistern. Endoscopic assistance enhances the exposure of the surgical field and accomplishes a valid instrument for intraventricular orientation to ease microsurgical procedures.

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How I do it: paramedian supracerebellar transtentorial approach for a temporomesial glioma

et al. 2021

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The paramedian supracerebellar transtentorial approach to the posterior fusiform gyrus

Abstract: The supracerebellar transtentorial approach is able to provide access to the posterior fusiform gyrus via a minimally disruptive, anatomic, microsurgical corridor.

Cited by 6 publications

References 15 publications

Supracerebellar transtentorial approach for left parahippocampal cavernous malformation

Supracerebellar transtentorial approach for left parahippocampal cavernous malformation

Endoscope-Assisted Neuroportal Transcerebellar Approach to the Fourth Ventricle: An Anatomical Study

How I do it: paramedian supracerebellar transtentorial approach for a temporomesial glioma

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