Contralateral Supracerebellar-Infratentorial Approach for Resection of Thalamic Cavernous Malformations

Operative Neurosurgery
Justin MascitelliM T Lawton

Abstract

Surgical resection of cavernous malformations (CM) in the posterior thalamus, pineal region, and midbrain tectum is technically challenging owing to the presence of adjacent eloquent cortex and critical neurovascular structures. Various supracerebellar infratentorial (SCIT) approaches have been used in the surgical armamentarium targeting lesions in this region, including the median, paramedian, and extreme lateral variants. Surgical view of a posterior thalamic CM from the traditional ipsilateral vantage point may be obscured by occipital lobe and tentorium. To describe a novel surgical approach via a contralateral SCIT (cSCIT) trajectory for resecting posterior thalamic CMs. From 1997 to 2017, 75 patients underwent the SCIT approach for cerebrovascular/oncologic pathology by the senior author. Of these, 30 patients underwent the SCIT approach for CM resection, and 3 patients underwent the cSCIT approach. Historical patient data, radiographic features, surgical technique, and postoperative neurological outcomes were evaluated in each patient. All 3 patients presented with symptomatic CMs within the right posterior thalamus with radiographic evidence of hemorrhage. All surgeries were performed in the sitting position. There wer...Continue Reading

References

Jan 1, 1976·Acta neurochirurgica·K Sano
Jul 1, 1995·Neurosurgery·G SinsonE S Flamm
Sep 3, 2010·Neurosurgical Focus·Adib A AblaRobert F Spetzler
May 30, 2015·Journal of Neurosurgery·Leonardo Rangel-Castilla, Robert F Spetzler
Oct 2, 2015·Clinical Neurology and Neurosurgery·Hisham Aboul-EneinAhmed Hafez Farhoud

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Citations

Mar 9, 2020·Neurosurgical Review·Martin Smrcka, Ondrej Navratil
Jun 5, 2021·Surgical Neurology International·Laura Beatriz López LópezJuan Casado Pellejero

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