8 Tentorial Incisura

2019 ◽  
Keyword(s):  
Tentorial Incisura

scholarly journals Posterior interhemispheric transtentorial approach for resection of a meningioma at the posteromedial tentorial incisura

2016 ◽  
Vol 40 (videosuppl1) ◽  
pp. 1 ◽  
Author(s):  
Sun Liyong ◽  
Yuhai Bao ◽  
Jiantao Liang ◽  
Mingchu Li ◽  
Jian Ren
Keyword(s):  
Third Ventricle ◽  
Symptomatic Improvement ◽  
Pineal Region ◽  
Increased Intracranial Pressure ◽  
Total Removal ◽  
Adjacent Structures ◽  
Patient Reported ◽  
Surgical Corridor ◽  
Tentorial Incisura ◽  
Transtentorial Approach

The posterior interhemispheric approach is a versatile approach to access lesions of the pineal region, posterior incisural space, posterior region of third ventricle, and adjacent structures. We demonstrate the case of a 26-year-old woman with symptoms of increased intracranial pressure and hydrocephalus caused by a meningioma at the posteromedial tentorial incisura. Gross-total removal of the tumor was successfully achieved via a posterior interhemispheric transtentorial approach. The patient reported an immediate and significant symptomatic improvement after surgery. The detailed operative technique and surgical nuances, including the surgical corridor, tentorium incision, tumor dissection and removal are illustrated in this video atlas.The video can be found here: https://youtu.be/nSNyjQKl7aE.

scholarly journals Meningioma of posterolateral tentorial incisura: a case demonstration of paramedian supracerebellar transtentorial approach

2021 ◽  
Vol 5 (1) ◽  
pp. V8
Author(s):  
Abdullah Keles ◽  
Burak Ozaydin ◽  
Mustafa K. Baskaya
Keyword(s):  
Pineal Region ◽  
Neurological Deficits ◽  
Total Resection ◽  
Tumor Extension ◽  
History Of ◽  
Tectal Plate ◽  
Pros And Cons ◽  
Ambient Cistern ◽  
Tentorial Incisura ◽  
Transtentorial Approach

The paramedian supracerebellar transtentorial approach allows unobstructed exposure to the quadrigeminal cistern, tectal plate, pineal region, tentorial incisura, medial basal temporal lobe, and posterior ambient cistern. The authors present a meningioma of the posterolateral tentorial incisura case in a 62-year-old male who presented with a long history of upper-extremity tremors and walking difficulties. MRI revealed supra- and infratentorial tumor extension and hydrocephalus. This approach enabled us to achieve gross-total resection without causing neurovascular injury or any postoperative neurological deficits. For each pathology, the pros and cons of various approaches should be considered based on the anatomy, vasculature, and any surrounding structures. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2138.

Transcranial Motor Evoked Potential Recording in a Case of Kernohan's Notch Syndrome: Case Report

Neurosurgery ◽  
2004 ◽  
Vol 54 (4) ◽  
pp. 999-1003 ◽  
Author(s):  
Devin K. Binder ◽  
Russ Lyon ◽  
Geoffrey T. Manley
Keyword(s):  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Cerebral Peduncle ◽  
Resonance Imaging ◽  
Left Hemiparesis ◽  
Electrophysiological Studies ◽  
Electrophysiological Findings ◽  
The Right ◽  
Tentorial Incisura ◽  
Potential Waveform

Abstract OBJECTIVE AND IMPORTANCE Compression of the cerebral peduncle against the tentorial incisura contralateral to a supratentorial mass lesion, the so-called Kernohan-Woltman notch phenomenon, can be an important cause of false localizing motor signs. Here, we demonstrate a case in which clinical, radiological, and electrophysiological findings were used together to define this syndrome. CLINICAL PRESENTATION A 21-year-old man sustained a left temporal depressed cranial fracture from a motor vehicle accident. Serial computed tomographic examinations demonstrated no evolution of hematomas or contusions, and he was managed nonsurgically with ventriculostomy for intracranial pressure control. Throughout his course in the neurosurgical intensive care unit, he displayed persistent left hemiparesis. INTERVENTION Further radiological and electrophysiological studies were undertaken in an attempt to explain his left hemiparesis. Brain magnetic resonance imaging demonstrated T2 prolongation in the central portion of the right cerebral peduncle extending to the right internal capsule. Electrophysiological studies using transcranial electrical motor evoked potentials revealed both a marked increase in voltage threshold, as well as a reduction in the complexity of the motor evoked potential waveform on the hemiparetic left side. This contrasted to significantly lower voltage threshold as well as a highly complex motor evoked potential waveform recorded on the relatively intact contralateral side. CONCLUSION This is the first time that clinical, radiological, and electrophysiological findings have been correlated in a case of Kernohan's notch syndrome. Compression of the contralateral cerebral peduncle against the tentorial incisura can lead to damage and ipsilateral hemiparesis. The anatomic extent of the lesion can be defined by magnetic resonance imaging and the physiological extent by electrophysiological techniques.

Tentorial Incisura

Neurosurgery ◽  
2000 ◽  
Vol 47 (suppl_3) ◽  
pp. S131-S153 ◽  
Author(s):  
Albert L. Rhoton
Keyword(s):  
Tentorial Incisura

Subtemporal Approach To The Tentorial Incisura: Normative Morphometric Data Based On Magnetic Resonance Imaging Scans

2006 ◽  
Vol 58 (suppl_1) ◽  
pp. ONS-22-ONS-28 ◽  
Author(s):  
Ardeshir Ardeshiri ◽  
Ardavan Ardeshiri ◽  
Emanuel Wenger ◽  
Markus Holtmannspötter ◽  
Peter A. Winkler
Keyword(s):  
Temporal Lobe ◽  
Middle Cranial Fossa ◽  
Axial Section ◽  
Subtemporal Approach ◽  
Rapid Acquisition ◽  
Coronal Section ◽  
Quadrigeminal Plate ◽  
Surgical Corridor ◽  
Tentorial Incisura ◽  
Tentorial Notch

Abstract OBJECTIVE: The tentorial notch can be contained within a transversal line made in front of the cerebral peduncles and another line through the posterior border of the quadrigeminal plate into the anterior, middle and posterior parts. Different approaches to the tentorial incisura have been established. The subtemporal approach represents one of those options. Since morphometrical analyses of this approach in this region have not yet been performed, the aim of the present study was to measure the surgical corridor along these borders. METHODS: Fifty-three magnetization prepared rapid acquisition gradient echo-sequences of individual brains without pathological lesions were analyzed. For this study, an axial section along the pontomesencephalic sulcus and two coronal sections along the above-described borders were measured using a program specially written by one of the coauthors to obtain various parameters. A triangle circumscribing the surgical corridor was delimited by exactly defined anatomic landmarks for the coronal section, and the depths of the temporal lobe at the incisural borders were measured for the axial section. RESULTS: Various data are given concerning the surgical corridor of a subtemporal approach to the tentorial incisura. The different shapes of this corridor to the incisural region were recorded. According to our measurements, four different types of the temporal lobe could be differentiated. CONCLUSION: Knowledge of these distances and various contours of the path is crucial to avoid brain damage during retraction or manipulation. The curvature of the floor of the middle cranial fossa is highly variable and thus determines the surgical path chosen.

scholarly journals Transzygomatic Approach to the Tentorial Incisura: Surgical Anatomy

Skull Base ◽  
1992 ◽  
Vol 2 (03) ◽  
pp. 161-166 ◽  
Author(s):  
Mario Ammirati ◽  
Jianya Ma ◽  
Donald Becker ◽  
Keith Black ◽  
Mel Cheatham ◽  
...  
Keyword(s):  
Surgical Anatomy ◽  
Tentorial Incisura

A Study to Analyze the Tentorial Incisura in Indian Population, for Racial Differences and Its Impact in the Outcome of Patients with Head Injury

2018 ◽  
Vol 07 (02) ◽  
pp. 122-128
Author(s):  
Deiveegan Kunjithapatham ◽  
Jeyaselvasenthilkumar Pachiyappan ◽  
Maria Fernand
Keyword(s):  
Head Injury ◽  
Racial Differences ◽  
Indian Population ◽  
Mean Values ◽  
Western Population ◽  
Typical Type ◽  
Autopsy Specimens ◽  
Tentorial Incisura ◽  
Tentorial Notch ◽  
Large Groups

Abstract Aim To measure the size of tentorial notch in Indian population, compare it with the western population from the literature available, and analyze the relation between size of tentorial notch and the outcome in patients with head injury. Materials and Methods The study was done using 10 cadavers and 15 autopsy specimens. In all the specimens, tentorial incisura was measured using vernier caliper after opening the skull and cutting the midbrain at the level of tentorial edge carefully without damaging the tentorium. All measurements were done in millimeters. Results Mean values, age-dependent mean values, and percentile values were calculated for various parameters in the tentorial incisura. Majority of the tentorial incisura are of typical type. Cases of tentorial incisura are significantly smaller in the age group of 20 to 25 years. Rate of deterioration of Glasgow coma scale (GCS) is rapid when the tentorial incisura is large. Conclusion There were no significant variations in measurements of tentorial incisura in Indian population compared with the western population. Rate of deterioration of GCS is higher in patients who had large tentorial incisura compared with other groups, which is statistically significance. However, this is to be confirmed by further study using large groups of patients to be used for clinical applications.

Magnetic Resonance Imaging of Kernohan's Notch

Neurosurgery ◽  
1990 ◽  
Vol 27 (2) ◽  
pp. 205-207 ◽  
Author(s):  
Alan R. Cohen ◽  
John Wilson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Nerve Palsy ◽  
Motor Deficit ◽  
Cerebral Peduncle ◽  
Resonance Imaging ◽  
Oculomotor Palsy ◽  
Extradural Hematoma ◽  
Tentorial Incisura ◽  
Supratentorial Mass

Abstract Compression of the cerebral peduncle against the tentorial incisura contralateral to a supratentorial mass, the so-called Kernohan's notch. can be a cause of false localizing motor signs. The authors present a case of Kernohan's notch secondary to a traumatic extradural hematoma. The patient developed an oculomotor palsy and a dense motor deficit ipsilateral to the extra-axial hematoma. Magnetic resonance imaging in the postoperative period clearly showed the midbrain lesion. The motor deficit and 3rd nerve palsy subsequently resolved.

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