Lesions of the superior cerebellar surface, pineal region, lateral and dorsal midbrain and mesial temporal lobe are challenging to treat and often require neurosurgical intervention.
The paramedian variation of the supracerebellar infratentorial approach utilizes the downward slope of the cerebellum to facilitate exposure and the lower density of cerebellar bridging veins away from the midline decreases the need to sacrifice larger venous channels. We also discuss our experiences with the approach, and some of the drawbacks and nuances that we have encountered as it has evolved over the years.
This approach is versatile and effective and the authors’ surgical approach of choice for resecting these challenging lesions.
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Conflicts of interest
Informed consent was obtained for the procedure illustrated. However, no IRB approval or patient consent is required per institutional policy for retrospective, single-cases in which no identifiable patient information is shared.
Electronic supplementary material
The authors demonstrate the successful access and resection of a midbrain cavernous malformation in a 34-year-old man following a symptomatic rebleeding using the paramedian supracerebellar infratentorial approach. (MP4 224,224 kb)
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La Pira, B., Sorenson, T., Quillis-Quesada, V. et al. The paramedian supracerebellar infratentorial approach. Acta Neurochir 159, 1529–1532 (2017). https://doi.org/10.1007/s00701-017-3196-y
- Supracerebellar infratentorial approach