The sub-occipital transtentorial approach revisited base on our own experience

2015 ◽  
Vol 61 (2-3) ◽  
pp. 168-175 ◽  
Author(s):  
C. Mottolese ◽  
A. Szathmari ◽  
A.C. Ricci-Franchi ◽  
P.A. Beuriat ◽  
B. Grassiot
Keyword(s):  
Occipital Transtentorial Approach ◽  
Transtentorial Approach

Arteriovenous Malformations of the Superior Cerebellar Artery: Excision via an Occipital Transtentorial Approach

Neurosurgery ◽  
1985 ◽  
Vol 17 (5) ◽  
pp. 749-756 ◽  
Author(s):  
Michael Salcman ◽  
Robert W. Nudelman ◽  
Edwin H. Bellis
Keyword(s):  
Arteriovenous Malformations ◽  
Superior Cerebellar Artery ◽  
Surgical Trauma ◽  
Recent Experience ◽  
Confined Space ◽  
Cerebellar Artery ◽  
Occipital Transtentorial Approach ◽  
Traditional Approaches ◽  
Surgical Extirpation ◽  
Transtentorial Approach

Abstract Arteriovenous malformations (AVMs) of the superior cerebellar artery (SCA) are unusual and difficult lesions to treat, representing less than half of all AVMs located in the posterior fossa. Traditional approaches for surgical extirpation include the subtemporal transtentorial and suboccipital supracerebellar routes. On the basis of our recent experience with three SCA-supplied AVMs, we advocate an occipital transtentorial approach similar to that used for neoplasms of the pineal gland. Exposure of the AVM from above and in the midline provides superior visualization of the deep veins, the SCA arborization in the retrocollicular space, and the rostral cerebellum, without exposing the temporal lobe and the 4th nerve to surgical trauma in a narrow, confined space. Superior cerebellar AVMs that arise from the caudal branch of the SCA on the superolateral aspect of the hemisphere are more easily handled by standard suboccipital methods.

scholarly journals Interhemispheric occipital transtentorial approach to the pineal region and dorsal midbrain

2018 ◽  
Vol 20 (1) ◽  
pp. 22-26
Author(s):  
Andrei Fernandes Joaquim ◽  
Marcos Juliano Dos Santos ◽  
Élton Gomes Da Silva ◽  
Hélder Tedeschi
Keyword(s):  
Surgical Anatomy ◽  
Pineal Region ◽  
Sitting Position ◽  
Technical Aspects ◽  
Pineal Region Tumors ◽  
Supracerebellar Infratentorial Approach ◽  
Occipital Transtentorial Approach ◽  
Transtentorial Approach ◽  
Wide Exposure

We describe the surgical anatomy and technical aspects of the interoccipital transtentorial approach to lesions of the dorsal midbrain and pineal region using the lateral-semiprone position. This approach offers a wide exposure of the posterior midbrain and pineal region tumors, avoiding the risks of the semi-sitting position used for the supracerebellar infratentorial approach. A step-by-step description of the approach is presented, with detailed anatomical pictures and case illustrations.

scholarly journals Right occipital transtentorial approach for a pineal malignant germ cell tumor

2021 ◽  
Vol 5 (1) ◽  
pp. V3
Author(s):  
Brian J. A. Gill ◽  
Dominique M. Higgins ◽  
Matei A. Banu ◽  
Michael G. Argenziano ◽  
Neil A. Feldstein ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Pineal Region ◽  
First Line ◽  
Intracranial Germ Cell Tumors ◽  
Somatic Transformation ◽  
Malignant Germ Cell Tumor ◽  
Occipital Transtentorial Approach ◽  
Malignant Lesions ◽  
Transtentorial Approach

Germ cell tumors account for up to 53% of the malignant lesions found in the pineal region and are typically managed with a combination of radiation therapy and chemotherapy. Malignant somatic transformation of intracranial germ cell tumors is exceedingly rare and has only been reported on two other occasions. Here the authors present the case of a pineal yolk sac tumor that failed optimum first-line treatment and underwent malignant somatic transformation to an enteric mucinous adenocarcinoma requiring surgical intervention. This video demonstrates the technical nuances of the occipital transtentorial approach and the safe microsurgical dissection of lesions within the pineal region. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2151.

Microsurgical approaches to the cerebellar interpeduncular region: qualitative and quantitative analysis

2021 ◽  
pp. 1-14
Author(s):  
Juan Leonardo Serrato-Avila ◽  
Juan Alberto Paz Archila ◽  
Marcos Devanir Silva da Costa ◽  
Paulo Ricardo Rocha ◽  
Sergio Ricardo Marques ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
The Other ◽  
Qualitative And Quantitative Analysis ◽  
Qualitative And Quantitative ◽  
Bridging Veins ◽  
Supracerebellar Infratentorial Approach ◽  
Occipital Transtentorial Approach ◽  
Cerebellar Lesions ◽  
Surgical Corridor ◽  
Transtentorial Approach

OBJECTIVE The cerebellar interpeduncular region (CIPR) is a gate for dorsolateral pontine and cerebellar lesions accessed through the supracerebellar infratentorial approach (SCITa), the occipital transtentorial approach (OTa), or the subtemporal transtentorial approach (STa). The authors sought to compare the exposures of the CIPR region that each of these approaches provided. METHODS Three approaches were performed bilaterally in eight silicone-injected cadaveric heads. The working area, area of exposure, depth of the surgical corridor, length of the interpeduncular sulcus (IPS) exposed, and bridging veins were statistically studied and compared based on each approach. RESULTS The OTa provided the largest working area (1421 mm2; p < 0.0001) and the longest surgical corridor (6.75 cm; p = 0.0006). Compared with the SCITa, the STa provided a larger exposure area (249.3 mm2; p = 0.0148) and exposed more of the length of the IPS (1.15 cm; p = 0.0484). The most bridging veins were encountered with the SCITa; however, no significant differences were found between this approach and the other approaches (p > 0.05). CONCLUSIONS To reach the CIPR, the STa provided a more extensive exposure area and more linear exposure than did the SCITa. The OTa offered a larger working area than the SCIT and the STa; however, the OTa had the most extensive surgical corridor. These data may help neurosurgeons select the most appropriate approach for lesions of the CIPR.

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