Skip to main content
Log in

Far lateral supracerebellar infratentorial approach for the treatment of upper brainstem gliomas: clinical experience with pediatric patients

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Objective

Surgical exposure of intrinsic lesions located lateral to the brainstem still represents a challenging task. The aim of this study was to assess the feasibility of the extracerebral far lateral supracerebellar infratentorial (FLSI) approach for the treatment of gliomas located in the upper brainstem in the pediatric population.

Methods and results

Between 1992 and 2002, seven patients (mean age 8.7 years) with tumors of glial origin (WHO I–IV) located mainly in the pontomesencephalic region were operated with the FLSI approach in a sitting position. Satisfactory extent of resection without additional morbidity was achieved.

Conclusion

In a carefully selected pediatric patient population, the FLSI approach proved to be a feasible and effective surgical route for the treatment of upper brainstem gliomas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ammirati M, Bernardo A, Musumeci A et al (2002) Comparison of different infratentorial–supracerebellar approaches to the posterior and middle incisural space: a cadaveric study. Neurosurgery 97:922–928

    Google Scholar 

  2. Ammirati M, Musumeci A, Bernardo A et al (2002) The microsurgical anatomy of the cisternal segment of the trochlear nerve, as seen through different neurosurgical operative windows. Acta Neurochir 144:1323–1327

    Google Scholar 

  3. Bricolo A (2000) Surgical management of intrinsic brain stem gliomas. Op Tech Neurosurg 3:137–154

    Google Scholar 

  4. Daspit CP, Spetzler RF, Pappas CT (1991) Combined approach for lesions involving the cerebellopontine angle and the skull base: experience with 20 cases—preliminary report. Otolaryngol Head Neck Surg 105:788–796

    Google Scholar 

  5. Epstein F, McCleary EL (1986) Intrinsic brain-stem tumors of childhood: surgical indications. J Neurosurg 64:11–15

    Google Scholar 

  6. Herrmann H-D, Winkler D, Westphal M (1992) Treatment of tumors of the pineal region and posterior part of the third ventricle. Acta Neurochir 116:137–146

    Google Scholar 

  7. Konovalov AN, Pitskhelauri DI (2001) Infratentorial supracerebellar approach to the colloid cysts of the third ventricle. Neurosurgery 49:1116–1123

    Google Scholar 

  8. Laborde G, Gilsbach JM, Harders A et al (1992) Experience with the infratentorial supracerebellar approach in lesions of the quadrigeminal region, posterior third ventricle, culmen cerebelli, and cerebellar peduncle. Acta Neurochir 114:135–138

    Google Scholar 

  9. Matsushima T, Fukui M, Suzuki S et al (1989) The microsurgical anatomy of the infratentorial lateral supracerebellar approach to the trigeminal nerve for Tic Douloureux. Neurosurgery 24:890–895

    Google Scholar 

  10. Ogata N, Yonekawa Y (1997) Paramedian supracerebellar approach to the upper brain stem and peduncular lesions. Neurosurgery 40:101–105

    Google Scholar 

  11. Pollack IF, Hoffman HJ, Humphreys RP, Becher L (1993) The long term outcome after surgical treatment of dorsally exophytic brain stem gliomas. J Neurosurg 78:859–863

    Google Scholar 

  12. Samii M, Carvalho GA, Tatagiba M et al (1996) Meningiomas of the tentorial notch: surgical anatomy and management. J Neurosurg 84:375–381

    Google Scholar 

  13. Spetzler RF, Daspit CP, Pappas CTE (1992) The combined supra- and infratetorial approach for lesions of the petrous and clival regions: experience with 46 cases. J Neurosurg 76:588–599

    Google Scholar 

  14. Türe U, Ozduman K, Elmaci I et al (2002) Infratentorial lateral supracerebellar approach for trochlear nerve schwannoma. J Clin Neurosci 9:595–598

    Google Scholar 

  15. Vishteh GA, David CA, Marciano FF et al (2000) Extreme lateral supracerebellar infratentorial approach to the posterolateral mesencephalon: technique and clinical experience. Neurosurgery 46:384–389

    Google Scholar 

  16. Wang C, Zhang J, Liu A et al (2000) Surgical treatment of primary midbrain gliomas. Surg Neurol 53:41–51

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to express our gratitude to Professor Wolfgang Seeger for his excellent illustrations. We would also like to thank Professor Martin Schumacher, Section of Neuroradiology, University of Freiburg for the MRI pictures.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vera Van Velthoven.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vougioukas, V.I., Omran, H., Gläsker, S. et al. Far lateral supracerebellar infratentorial approach for the treatment of upper brainstem gliomas: clinical experience with pediatric patients. Childs Nerv Syst 21, 1037–1041 (2005). https://doi.org/10.1007/s00381-005-1140-6

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-005-1140-6

Keywords

Navigation