Infratentorial supracerebellar approach for microsurgical resection of large midline pineal region tumor: a technical note

Authors

  • Ricardo Santos de Oliveira Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
  • Dinark Conceição Viana Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
  • Matheus Fernando Manzolli Ballestero Department of Medicine, Federal University of São Carlos, São Carlos, Brazil

DOI:

https://doi.org/10.29327/apn.v1i1(September-December).11

Keywords:

Tumor, Pineal, Park bench, Superior cerebellar

Abstract

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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Author Biographies

Ricardo Santos de Oliveira, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil

President of the Brazilian Pediatric Neurosurgery Society (2019-2021)

Member of the International Society for Pediatric Neurosurgery (ISPN)

Member of the Asian-Australasian Society of  Pediatric Neurosurgery (AASPN)

Member of Internacional Federation of Neuroendoscopy (IFNE)

Division of Pediatric Neurosurgery - São Lucas Hospital

Associate Professor / Livre-Docente - Division of  Neurosurgery Hospital das Clínicas - School of Medicine of Ribeirao Preto University of Sao Paulo Av. Bandeirantes, 3900, Monte Alege, CEP 14049-900, Ribeirao Preto, Sao Paulo, Brazil

Dinark Conceição Viana, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil

Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil

Matheus Fernando Manzolli Ballestero , Department of Medicine, Federal University of São Carlos, São Carlos, Brazil

Department of Medicine, Federal University of São Carlos, São Carlos, Brazil

Published

2019-12-19 — Updated on 2019-12-19

How to Cite

1.
de Oliveira RS, Viana DC, Ballestero MFM. Infratentorial supracerebellar approach for microsurgical resection of large midline pineal region tumor: a technical note. Arch Pediat Neurosurg [Internet]. 2019Dec.19 [cited 2021Oct.18];1(1(September-December):29-31. Available from: https://www.archpedneurosurg.com.br/pkp/index.php/sbnped2019/article/view/11

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Section

Historical Vignettes, Obituaries, Etc.

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