Indications An occipital transtentorial craniotomy can provide excellent exposure for falcotentorial meningiomas and any lesion arising from the precentral cerebellar fissure, posterior incisural space, and adjoining structures. Contraindications Standard medical contraindications for prone positioning. Patent foramen ovale with positive bubble…
Indications This approach provides optimal exposure for lesions in the pineal region, posterior third ventricle, and posterior mesencephalon with minimal to no damage to the healthy parenchyma and surrounding structures. You’re Reading a Preview Become a Clinical Tree membership for…
Indications The expanded endonasal transsphenoidal approach is employed for various pathologies involving the sella, suprasellar space, and sphenoid bone, including pituitary adenomas, Rathke pouch cyst, and craniopharyngiomas. Other indications include clival chordomas, meningiomas, metastatic lesions, and medial temporal lobe lesions…
Indications Tumors of the lateral and anterior third ventricles. Contraindications The transcallosal approach, although it provides exposure to tumors in the lateral and anterior third ventricle, is limited in providing satisfactory access to tumors in the posterior trigone, temporal horn,…
There are multiple variations of the presigmoid approach to the posterior fossa: retrolabyrinthine, transcrusal, translabyrinthine, transotic, and transcochlear. Each variation increases the amount of temporal bone resected, which increases the surgical freedom at the expense of increased surgical morbidity of…
Indications Lesions in the cerebellopontine angle and petroclival region can be surgically challenging to resect because of surrounding vascular and eloquent neural structures (i.e., brainstem) that have zero tolerance for retraction. Numerous surgical approaches, such as translabyrinthine, transcochlear, and presigmoid…
Indications Majority of the posterior fossa lesions Chiari malformations and other developmental abnormalities Brain tumors including meningiomas, ependymomas, astrocytomas, and medulloblastomas Vascular lesions such as aneurysms, cavernous malformations, arteriovenous malformations, and hemangioblastomas ( Fig. 5.1 ) Posterior fossa infections Contraindications…
Indications This technique is effective for lesions of the middle fossa (i.e., cavernous sinus, medial temporal lobe, tentorial region, petrous bone, incisura) and posterior fossa (i.e., extraaxial lesions in the petroclival region, intraaxial lesions in the anteromedial region of the…
Indications The frontotemporal “pterional” craniotomy is considered the workhorse of skull base approaches. Temporal lobectomy in patients with medically refractory epilepsy (anterior temporal lobectomy versus selective amygdalohippocampectomy) Removal of sphenoid wing meningiomas and intrinsic frontal/temporal lobe tumors Access to the…
Indications The occipital craniotomy is an adaptable approach that allows us to access lesions, vascular malformations, and congenital abnormalities located at the occipital lobes, tentorium, torcular herophili, transverse sinus, and sigmoid sinus. Contraindications Any pathology located in the cervical spine…