Infratentorial supracerebellar approach for microsurgical resection of large midline pineal region tumor: a technical note
Keywords:Tumor, Pineal, Park bench, Superior cerebellar
Pineal region tumors pose certain challenges regarding to their resection: a deep surgical field, associated critical surrounding neurovascular structures, and narrow operative working corridor due to obstruction by the apex of the culmen. The authors describe a midline supracerebellar infratentorial approach that is routinely performed and was successfully used in the treatment of a large midline pineal region tumor in a 4 years old child. The surgeon achieved generous exposure of the caudal midline mesencephalon through a "cross-court" midline or oblique trajectory, while avoiding excessive retraction on the culmen demonstrating that large midline pineal region tumors can be removed through a suboccipital craniotomy. This approach is safe, may spare some of the midline vermian bridging veins, and may be potentially less invasive and more efficient than other surgical techniques.
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Copyright (c) 2019 Ricardo Santos de Oliveira, Dinark Conceição Viana, Matheus Fernando Manzolli Ballestero
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