Subtonsillar-transcerebellomedullary approach to lesions involving the fourth ventricle, the cerebellomedullary fissure and the lateral brainstem

Ziyal I., Sekhar L., Salas E.

BRITISH JOURNAL OF NEUROSURGERY, cilt.13, sa.3, ss.276-284, 1999 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 13 Sayı: 3
  • Basım Tarihi: 1999
  • Doi Numarası: 10.1080/02688699943682
  • Dergi Adı: BRITISH JOURNAL OF NEUROSURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.276-284
  • Anahtar Kelimeler: brainstem tumour, cavernous angioma, distal PICA aneurysm, subtonsillar-transcerebellomedullary approach, INFERIOR CEREBELLAR ARTERY, MICRO-SURGICAL ANATOMY, 4TH VENTRICLE, VASCULAR MALFORMATIONS, CAVERNOUS ANGIOMA, STEM, SURGERY, ANEURYSMS, FLOOR
  • Marmara Üniversitesi Adresli: Hayır

Özet

We describe the use of the subtonsillar-transcerebellomedullary approach to laterally placed fourth ventricle and brain-stem lesions. The subtonsillar-transcerebellomedullary approach to the fourth ventricle and the lateral brainstem was used in six patients: three patients with tumours of the fourth ventricle and brainstem (two ependymomas and one papillary thyroid carcinoma metastasis), two patients with cavernous angiomas of the brainstem and one patient with a distal posterior inferior cerebellar artery (PICA) aneurysm. The microsurgical anatomy of this approach was studied in five cadaveric head specimens. The rumours and cavernous angiomas were removed and the distal PICA aneurysm was clipped successfully. In all patients the Karnofsky performance scale (KPS) was equal to or better than the preoperative status on follow-up examinations. The anatomical studies also revealed the extensive exposure provided with this approach. The subtonsillar-transcerebellomedullary approach is recommended for lesions occupying the cerebellomedullary fissure, and the lateral aspect of the fourth ventricle.