Acta Neurochirurgica

, Volume 157, Issue 11, pp 1971–1974 | Cite as

Minimally invasive subfrontal route for the resection of medial temporal region intrinsic tumors

  • Giannantonio SpenaEmail author
  • Pier Paolo Panciani
  • Federico Nicolosi
  • Marco Fontanella
How I Do it - Brain Tumors



The mesial temporal region (MTR) comprises important components of the limbic system, as well as vital neurovascular structures. Because of its important functional role, as much healthy brain tissue as possible must be preserved while targeting resection of MTR lesions.


A frontal minicraniotomy is used to access the MTR through a subfrontal approach. By opening the most medial part of the Sylvian fissure, the uncus-amygdala complex is exposed, and through this, the head of the hippocampus can be reached and removed as well.


This approach is extremely suitable for MTR lesions, as it provides the advantage of sparing the most important functional structures of the temporal lobe, the temporal stem, and the limen insulae, as well as the optic radiations and the fronto-occipital connections.


Medial temporal region Limbic system Gliomas Uncus Amygdala Minimally invasive 


Compliance with ethical standards

Authors’ statement of conflict of interest

All Authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants, participation in speakers’ bureaus, membership, employment, consultancies, stock ownership or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Supplementary material


In this video a case of low-grade glioma of the medial temporal region is presented. All the surgical steps are shown, starting from the craniotomy, the trajectories and the subpial technique used to remove the tumor. (MP4 215065 kb)


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Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  • Giannantonio Spena
    • 1
    Email author
  • Pier Paolo Panciani
    • 1
  • Federico Nicolosi
    • 1
  • Marco Fontanella
    • 1
  1. 1.Clinic of NeurosurgerySpedali Civili and University of BresciaBresciaItaly

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