American Association of Neurological Surgeons | Lt suboccipital supracerebellar transtentorial approach for resect. of tectal cavernous malformation @AANSNeurosurgery | Uploaded May 2020 | Updated October 2024, 1 day ago.
Hussam Abou-Al-Shaar, MD,1 Timothy G. White, MD,2 Ivo Peto, MD,2 and Amir R. Dehdashti, MD2
1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and 2Department of Neurosurgery, Hofstra Northwell School of Medicine, Manhasset, New York
A 64-year-old man with a midbrain cavernoma and prior bleeding presented with a 1-week history of diplopia, partial left oculomotor nerve palsy, and worsening dysmetria and right-sided weakness. MRI revealed a hemorrhagic left tectal plate and midbrain cavernoma. A left suboccipital supracerebellar transtentorial approach in the sitting position was performed for resection of his lesion utilizing the lateral mesencephalic sulcus safe entry zone. Postoperatively, he developed a partial right oculomotor nerve palsy; imaging depicted complete resection of the cavernoma. He recovered from the right third nerve palsy, weakness, and dysmetria, with significant improvement of his partial left third nerve palsy.
**Intro music: "Daybreak" by Graeme Rosner
Hussam Abou-Al-Shaar, MD,1 Timothy G. White, MD,2 Ivo Peto, MD,2 and Amir R. Dehdashti, MD2
1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and 2Department of Neurosurgery, Hofstra Northwell School of Medicine, Manhasset, New York
A 64-year-old man with a midbrain cavernoma and prior bleeding presented with a 1-week history of diplopia, partial left oculomotor nerve palsy, and worsening dysmetria and right-sided weakness. MRI revealed a hemorrhagic left tectal plate and midbrain cavernoma. A left suboccipital supracerebellar transtentorial approach in the sitting position was performed for resection of his lesion utilizing the lateral mesencephalic sulcus safe entry zone. Postoperatively, he developed a partial right oculomotor nerve palsy; imaging depicted complete resection of the cavernoma. He recovered from the right third nerve palsy, weakness, and dysmetria, with significant improvement of his partial left third nerve palsy.
**Intro music: "Daybreak" by Graeme Rosner
