Michael G Hart1, Thomas Santarius, Ramez W Kirollos. 1. Department of Neurosurgery, Division of Neurosciences, Addenbrooke's Hospital, Box 166, Cambridge, CB2 0QQ, UK. mikehart82@me.com
Abstract
BACKGROUND: Resection of a pineal tumour requires fastidious pre-operative planning to select the optimal surgical approach and maximise resection while minimising morbidity. METHOD: To describe and compare the supracerebellar infratentorial and occipital transtentorial approaches. CONCLUSIONS: Specific considerations include patient-specific anatomy, extent and relationships of the tumour, and the techniques likely to be employed during resection. The supracerebellar infratentorial approach provides a direct corridor to pineal tumours caudal to the deep veins; for tumours invaginating the tectal plate in a caudal direction the occipital transtentorial provides a better view.
BACKGROUND: Resection of a pineal tumour requires fastidious pre-operative planning to select the optimal surgical approach and maximise resection while minimising morbidity. METHOD: To describe and compare the supracerebellar infratentorial and occipital transtentorial approaches. CONCLUSIONS: Specific considerations include patient-specific anatomy, extent and relationships of the tumour, and the techniques likely to be employed during resection. The supracerebellar infratentorial approach provides a direct corridor to pineal tumours caudal to the deep veins; for tumours invaginating the tectal plate in a caudal direction the occipital transtentorial provides a better view.