scholarly journals Supracerebellar Transtentorial Approach for Resection of a Recurrent Geniculate Thalamic Cavernous Malformation: 2-Dimensional Operative Video

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Visish M. Srinivasan ◽  
Rohin Singh ◽  
Jakub Godzik ◽  
Joshua S. Catapano ◽  
Michael T. Lawton
Keyword(s):  
Cavernous Malformation ◽  
Transtentorial Approach

Contralateral supracerebellar-transtentorial approach for posterior medio-basal temporal cavernous malformation resection

2021 ◽  
Author(s):  
Fabio A. Frisoli ◽  
Jacob F. Baranoski ◽  
Joshua S. Catapano ◽  
Michael J. Lang ◽  
Michael T. Lawton
Keyword(s):  
Cavernous Malformation ◽  
Transtentorial Approach

scholarly journals Pretemporal transcavernous transtentorial approach for right pontine cavernous malformation

2019 ◽  
Vol 1 (1) ◽  
pp. V5 ◽  
Author(s):  
Xavier T. J. Hsu ◽  
Chih-Hsiang Liao ◽  
Chun-Fu Lin ◽  
Sanford P. C. Hsu
Keyword(s):  
Mental Status ◽  
Cavernous Malformation ◽  
Vascular Lesion ◽  
Slow Flow ◽  
Total Removal ◽  
Posterior Clinoid Process ◽  
Acute Changes ◽  
The Right ◽  
Surgical Corridor ◽  
Transtentorial Approach

A 57-year-old man presented with acute changes in mental status. Brain CT showed a high-density lesion at the pons. Brain MRA revealed a very slow-flow vascular lesion at the right aspect of the pons, about 3.9 ⋅ 3.0 ⋅ 3.0 cm3, compatible with a pontine cavernous malformation (CM). Gross-total removal was achieved. In this approach, a wider surgical corridor was obtained by opening the Meckel’s cave and cutting the tentorium. For a midline attack point on the pons, additional removal of the posterior clinoid process can meet the goal. In the authors’ opinion, this approach is safe and effective in selected ventrolateral pontine CMs.The video can be found here: https://youtu.be/moHqEkp5eCA.

scholarly journals Supracerebellar Transtentorial Approach for Mesial Temporal Lobe Cavernous Malformation: 2-Dimensional Operative Video

2019 ◽  
Vol 17 (6) ◽  
pp. E236-E236 ◽  
Author(s):  
Benjamin K Hendricks ◽  
Robert F Spetzler
Keyword(s):  
Cavernous Malformation ◽  
Video Recording ◽  
Complete Removal ◽  
Institutional Review Board ◽  
Cavernous Malformations ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
Stereotactic Navigation ◽  
Mesial Temporal Lobe ◽  
Transtentorial Approach

Abstract Medial temporal cavernous malformations can involve transgression of eloquent parenchyma. For a tentorium-abutting temporal cavernous malformation, the supracerebellar transtentorial corridor is a suitable approach with minimal parenchymal insult. Using dynamic and gravity retraction, lighted bipolar forceps and suction, and stereotactic navigation, this trajectory provides a minimally invasive corridor. The patient in this case has a medial temporal cavernous malformation, with the lesion abutting the tentorial leaflet. The cavernous malformation is accessed and removed in a piecemeal manner. Complete removal of the lesion is achieved. The patient remained neurologically stable after the procedure. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

Subtemporal transtentorial approach for resection of a pontomesencephalic cavernous malformation

2019 ◽  
Vol 1 (2) ◽  
pp. V10
Author(s):  
Georgios A. Zenonos ◽  
Samir Sur ◽  
Maximiliano Nuñez ◽  
David T. Fernandes-Cabral ◽  
Jacques J. Morcos
Keyword(s):  
Cavernous Malformation ◽  
3D Video ◽  
Fiber Tractography ◽  
High Definition ◽  
Entry Zone ◽  
Link Type ◽  
Transtentorial Approach

In this 3D video we review the case of a pontomesencephalic cavernous malformation in a 27-year-old woman who presented with hemiparesis and diplopia. The cavernous malformation was completely resected through a subtemporal transtentorial approach and an epitrigeminal brainstem entry zone, with a significant improvement in the patient’s hemiparesis. The relevant anatomy is reviewed in detail through multiple anatomical brainstem dissection specimens, as well as high-definition fiber tractography images. The rationale for the approach is analyzed relative to other possible options, and a number of technical pearls are provided.The video can be found here: https://youtu.be/8EoIWL7XqAc.

scholarly journals Endoscope-assisted supracerebellar transtentorial approach to the posterior medial temporal lobe for resection of cavernous malformation

2016 ◽  
Vol 40 (videosuppl1) ◽  
pp. 1
Author(s):  
M. Yashar S. Kalani ◽  
Ting Lei ◽  
Nikolay L. Martirosyan ◽  
Mark E. Oppenlander ◽  
Robert F. Spetzler ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Cavernous Malformation ◽  
Patient Positioning ◽  
Anterolateral Approach ◽  
Subtemporal Approach ◽  
Vein Of Labbé ◽  
Mesial Temporal Lobe ◽  
Tentorial Incisura ◽  
Transtentorial Approach

The mesial temporal lobe can be approached via a pterional or orbitozygomatic craniotomy, the subtemporal approach, or transcortically. Alternatively, the entire mesial temporal lobe can be accessed using a lateral supracerebellar transtentorial (SCTT) approach. Here we describe the technical nuances of patient positioning, craniotomy, supracerebellar dissection, and tentorial disconnection to traverse the tentorial incisura to arrive at the posterior mesial temporal lobe for a cavernous malformation. The SCTT approach is especially useful for lesions in the dominant temporal lobe where an anterolateral approach may endanger language centers or the vein of Labbé.The video can be found here: https://youtu.be/D8mIR5yeiVw.

scholarly journals Supracerebellar transtentorial approach to the tentorial incisura and beyond

2016 ◽  
Vol 40 (videosuppl1) ◽  
pp. 1 ◽  
Author(s):  
Kyle I. Swanson ◽  
Ulas Cikla ◽  
Kutluay Uluc ◽  
Mustafa K. Baskaya
Keyword(s):  
Temporal Lobe ◽  
Cavernous Malformation ◽  
Link Type ◽  
Suboccipital Craniotomy ◽  
Tentorial Meningioma ◽  
Eloquent Cortex ◽  
Tentorial Incisura ◽  
Transtentorial Approach

The supracerebellar transtentorial approach via a suboccipital craniotomy provides a corridor to reach lesions of the tentorial incisura and supratentorial lesions of the posterior medial basal temporal lobe, such as lesions of the posterior parahippocampal and fusiform gyri. The supracerebellar transtentorial approach obviates the need for either retraction of eloquent cortex or a transcortical route to reach lesions in this region. We present three cases that demonstrate the utility of this approach: a left-sided tentorial meningioma with superior projection, a left-sided posterior parahippocampal cavernous malformation, and a left-sided posterior parahippocampal grade 2 oligodendroglioma.The video can be found here: https://youtu.be/OLnzUGZfUqk.

scholarly journals Contralateral supracerebellar transtentorial approach for a thalamic cavernous malformation resection: operative video

2019 ◽  
Vol 1 (1) ◽  
pp. V21
Author(s):  
Sirin Gandhi ◽  
Tsinsue Chen ◽  
Justin R. Mascitelli ◽  
Claudio Cavallo ◽  
Mohamed A. Labib ◽  
...  
Keyword(s):  
Visual Field ◽  
Cavernous Malformation ◽  
Sitting Position ◽  
Lateral Aspect ◽  
Homonymous Hemianopsia ◽  
Link Type ◽  
Visual Field Deficits ◽  
Motor Strength ◽  
Cerebellar Retraction ◽  
Transtentorial Approach

This video illustrates a contralateral supracerebellar transtentorial (cSCTT) approach for resection of a ruptured thalamic cavernous malformation in a 56-year-old woman with progressive right-sided homonymous hemianopsia. The patient was placed in the sitting position, and a torcular craniotomy was performed for the cSCTT approach. The lesion was resected completely. Postoperatively, the patient had intact motor strength and baseline visual field deficits with moderate right-sided paresthesias. The cSCTT approach maximizes the lateral surgical reach without the cortical transgression seen with alternative transcortical routes.1 Contralaterality is a defining feature, with entry of the neurosurgeon’s instruments from the craniotomy edge of the craniotomy, contralateral to the lesion, allowing access to the lateral aspect of the lesion. The sitting position facilitates gravity-assisted cerebellar retraction and enhances the superior reach of this approach (Used with permission from Barrow Neurological Institute, Phoenix, Arizona).The video can be found here: https://youtu.be/lqB9mu_T8NQ.

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