American Association of Neurological Surgeons | Contralateral supracerebellar transtentorial approach for thalamic cavernous malformation resection @AANSNeurosurgery | Uploaded August 2020 | Updated October 2024, 1 day ago.
Sirin Gandhi, MD, Tsinsue Chen, MD, Justin R. Mascitelli, MD, Claudio Cavallo, MD, Mohamed A. Labib, MD, Michael J. Lang, MD, and Michael T. Lawton, MD
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
Abstract
This video illustrates a contralateral supracerebellar transtentorial (cSCTT) approach for resection of a ruptured thalamic cavernous malformation in a 56-year-old woman with progressive right-sided homonymous hemianopsia. The patient was placed in the sitting position, and a torcular craniotomy was performed for the cSCTT approach. The lesion was resected completely. Postoperatively, the patient had intact motor strength and baseline visual field deficits with moderate right-sided paresthesias. The cSCTT approach maximizes the lateral surgical reach without the cortical transgression seen with alternative transcortical routes.1 Contralaterality is a defining feature, with entry of the neurosurgeon’s instruments from the craniotomy edge of the craniotomy, contralateral to the lesion, allowing access to the lateral aspect of the lesion. The sitting position facilitates gravity-assisted cerebellar retraction and enhances the superior reach of this approach (Used with permission from Barrow Neurological Institute, Phoenix, Arizona).
**Intro music: "Daybreak" by Graeme Rosner
Sirin Gandhi, MD, Tsinsue Chen, MD, Justin R. Mascitelli, MD, Claudio Cavallo, MD, Mohamed A. Labib, MD, Michael J. Lang, MD, and Michael T. Lawton, MD
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
Abstract
This video illustrates a contralateral supracerebellar transtentorial (cSCTT) approach for resection of a ruptured thalamic cavernous malformation in a 56-year-old woman with progressive right-sided homonymous hemianopsia. The patient was placed in the sitting position, and a torcular craniotomy was performed for the cSCTT approach. The lesion was resected completely. Postoperatively, the patient had intact motor strength and baseline visual field deficits with moderate right-sided paresthesias. The cSCTT approach maximizes the lateral surgical reach without the cortical transgression seen with alternative transcortical routes.1 Contralaterality is a defining feature, with entry of the neurosurgeon’s instruments from the craniotomy edge of the craniotomy, contralateral to the lesion, allowing access to the lateral aspect of the lesion. The sitting position facilitates gravity-assisted cerebellar retraction and enhances the superior reach of this approach (Used with permission from Barrow Neurological Institute, Phoenix, Arizona).
**Intro music: "Daybreak" by Graeme Rosner
