Browsing by Subject "Supracerebellar approach"

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    Resection of a Pineal Region Papillary Tumor Using Robotic Exoscope: Improved Visualization and Ergonomics for Deep Seeded Tumor
    (American Association of Neurological Surgeons, 2021-07-01) Huff, Wei X.; Witten, Andrew J.; Shah, Mitesh V.; Neurological Surgery, School of Medicine
    Surgery for pineal region tumors is technically challenging due to their deep location and close proximity to critical deep venous structures, midbrain, and thalamus. A high-definition video exoscope was recently proposed as an alternative to the operating microscope. The authors illustrate a case of the midline supracerebellar infratentorial approach to resect a pineal region tumor using the Modus V exoscope and demonstrate the improved visualization of critical structures in this deep location. Additionally, the marked improvement in surgeon comfort suggests that this system may have significant advantages over traditional microscope-based surgery for tumors of the pineal region. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2127.
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    The extended supracerebellar transtentorial approach for resection of medial tentorial meningiomas
    (Scientific Scholar, 2014-03-15) Ansari, Shaheryar F.; Young, Ronald L.; Bohnstedt, Bradley N.; Cohen‑Gadol, Aaron A.; Neurological Surgery, School of Medicine
    Background: The supracerebellar transtentorial (SCTT) approach has been established as a safe corridor to access the posteriomedial basal temporal region. Previous reports have demonstrated the efficacy of this route in the resection of intrinsic tumors and small arteriovenous malformations. Only one report in the English literature has described its use to resect a medial tentorial meningioma. Methods: The authors discuss the relevant surgical anatomy of this approach and its advantages compared with more traditional routes, and illustrate its application to remove medial tentorial meningiomas through two operative cases with accompanying videos. Results: In illustrative case one, the patient recovered from surgery with no deficits. All his preoperative symptoms had resolved at 3-month follow-up. At the 4-year follow-up, MRI did not demonstrate any growth of the residual tumor. In case two, gross total resection was achieved and the patient did not suffer any postoperative language or visual deficit. At 2-year follow-up, no tumor recurrence was present. Conclusion: The SCTT approach has a potential to safely access extra-axial lesions located around the medial tentorial incisura. As demonstrated in these two cases, the approach merits consideration in patients with tentorial meningiomas as an alternative to more widely utilized skull base approaches and subtemporal routes.