Experience with the Infratentorial Supracerebellar Approach in Lesions of the Quadrigeminal Region, Posterior Third Ventricle, Culmen Cerebelli, and Cerebellar Peduncle

Overview

Journal Acta Neurochir (Wien)

Specialty Neurosurgery

Date 1992 Jan 1

PMID 1580192

Citations 5

Authors

G Laborde

J M Gilsbach

A Harders

W Seeger

Affiliations

Soon will be listed here.

Abstract

We report about our experience with the infratentorial supracerebellar approach in 23 patients operated on for lesions located in the posterior part of the third ventricle, quadrigeminal plate, culmen cerebelli and cerebellar peduncle. Three patients had transient worsening of their deficits immediately after surgery. Three patients developed haemorrhages postoperatively requiring surgical evacuation. One of them died. None of the patients developed specific complications which could without any doubt be attributed to the approach. We concluded that in combination with intra-operative CSF drainage and the sitting position the infratentorial supracerebellar approach allows safe access to lesions situated in an area limited by the posterior part of the third ventricle, the fastigium level and both cerebellar peduncles.

Citing Articles

The Use of the Suboccipital Transtentorial Approach to the Posterior Inferior Incisural Space.

Bal J, Fairhead R, Matloob S, Shapey J, Romani R, Gavin C Cureus. 2023; 15(10):e47705.

PMID: 38021782 PMC: 10674890. DOI: 10.7759/cureus.47705.

Dorsal extensions of the fastigium cerebelli: an anatomical study using magnetic resonance imaging.

Tsutsumi S, Fernandez-Miranda J, Ishii H, Ono H, Yasumoto Y Surg Radiol Anat. 2018; 40(7):829-834.

PMID: 29651568 DOI: 10.1007/s00276-018-2023-3.

Microsurgical resection of tumors of the lateral and third ventricles: operative corridors for difficult-to-reach lesions.

Cikla U, Swanson K, Tumturk A, Keser N, Uluc K, Cohen-Gadol A J Neurooncol. 2016; 130(2):331-340.

PMID: 27235145 PMC: 5090015. DOI: 10.1007/s11060-016-2126-9.

Electrophysiological validation of a human prototype auditory midbrain implant in a guinea pig model.

Lenarz M, Lim H, Patrick J, Anderson D, Lenarz T J Assoc Res Otolaryngol. 2006; 7(4):383-98.

PMID: 17075701 PMC: 2504634. DOI: 10.1007/s10162-006-0056-5.

Far lateral supracerebellar infratentorial approach for the treatment of upper brainstem gliomas: clinical experience with pediatric patients.

Vougioukas V, Omran H, Glasker S, Van Velthoven V Childs Nerv Syst. 2005; 21(12):1037-41.

PMID: 15800790 DOI: 10.1007/s00381-005-1140-6.

References

Lazar M, Clark K . Direct surgical management of masses in the region of the vein of Galen. Surg Neurol. 1974; 2(1):17-21. View

Pendl G, Vorkapic P . Microsurgery of midbrain lesions. Acta Neurochir Suppl (Wien). 1988; 42:130-6. DOI: 10.1007/978-3-7091-8975-7_26. View

Kobayashi S, Sugita K, Tanaka Y, Kyoshima K . Infratentorial approach to the pineal region in the prone position: Concorde position. Technical note. J Neurosurg. 1983; 58(1):141-3. DOI: 10.3171/jns.1983.58.1.0141. View

Suzuki J, Iwabuchi T . Surgical removal of pineal tumors (pinealomas and teratomas). Experience in a series of 19 cases. J Neurosurg. 1965; 23(6):565-71. DOI: 10.3171/jns.1965.23.6.0565. View

Sano K . Diagnosis and treatment of tumours in the pineal region. Acta Neurochir (Wien). 1976; 34(1-4):153-7. DOI: 10.1007/BF01405869. View

Yamamoto I, Rhoton Jr A, Peace D . Microsurgery of the third ventricle: Part I. Microsurgical anatomy. Neurosurgery. 1981; 8(3):334-56. DOI: 10.1227/00006123-198103000-00006. View

OBRADOR S, Soto M . Surgical management of tumours of the pineal region. Acta Neurochir (Wien). 1976; 34(1-4):159-71. DOI: 10.1007/BF01405870. View

JAMIESON K . Excision of pineal tumors. J Neurosurg. 1971; 35(5):550-3. DOI: 10.3171/jns.1971.35.5.0550. View

Glasauer F . An operative approach to pineal tumors. Acta Neurochir (Wien). 1970; 22(2):177-80. DOI: 10.1007/BF01401167. View

10.

REID W, Clark W . Comparison of the infratentorial and transtentorial approaches to the pineal region. Neurosurgery. 1978; 3(1):1-8. DOI: 10.1227/00006123-197807000-00001. View

11.

Rappaport Z, SHALIT M . Perioperative external ventricular drainage in obstructive hydrocephalus secondary to infratentorial brain tumours. Acta Neurochir (Wien). 1989; 96(3-4):118-21. DOI: 10.1007/BF01456169. View

12.

Stone J, Cybulski G, CROWELL R, Moody R . The lateral position--dependant occipital approach--to pineal and medial occipitoparietal lesions. Technical note. Acta Neurochir (Wien). 1990; 102(3-4):133-6. DOI: 10.1007/BF01405427. View

13.

LAPRAS C, Patet J, Mottolese C, Lapras Jr C . Direct surgery for pineal tumors: occipital-transtentorial approach. Prog Exp Tumor Res. 1987; 30:268-80. DOI: 10.1159/000413684. View

14.

Rhoton Jr A, Yamamoto I, Peace D . Microsurgery of the third ventricle: Part 2. Operative approaches. Neurosurgery. 1981; 8(3):357-73. DOI: 10.1227/00006123-198103000-00007. View

15.

POPPEN J . The right occipital approach to a pinealoma. J Neurosurg. 1966; 25(6):706-10. DOI: 10.3171/jns.1966.25.6.0706. View

16.

Page L . The infratentorial-supracerebellar exposure of tumors in the pineal area. Neurosurgery. 1977; 1(1):36-40. DOI: 10.1227/00006123-197707000-00008. View

17.

STEIN B . The infratentorial supracerebellar approach to pineal lesions. J Neurosurg. 1971; 35(2):197-202. DOI: 10.3171/jns.1971.35.2.0197. View

18.

HEIMBURGER R . Positional oculogyric crises. Case report. J Neurosurg. 1988; 69(6):951-3. DOI: 10.3171/jns.1988.69.6.0951. View

19.

Fahlbusch R, Strauss C, Huk W, Rockelein G, Kompf D, Ruprecht K . Surgical removal of pontomesencephalic cavernous hemangiomas. Neurosurgery. 1990; 26(3):449-56; discussion 456-7. DOI: 10.1097/00006123-199003000-00012. View