Supracerebellar infratentorial inverted subchoroidal approach to lateral ventricle lesions: Anatomical study and illustrative case

Authors

Irakliy Abramov, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States.Follow
Xiaochun Zhao, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States.Follow
Evgenii Belykh, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States.Follow
Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States.Follow
David Pitskhelauri, Department of Neuro-oncology, Burdenko Neurosurgery Center, Moscow, Russian Federation.
Mark C. Preul, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States.Follow

Document Type

Article

Abstract

Background: This study provides an anatomical description of a novel supracerebellar infratentorial inverted subchoroidal (SIIS) approach to the lateral ventricle. An illustrative case is presented in which this approach was used to simultaneously resect two tumors residing in the posterior fossa and lateral ventricle. Methods: The SIIS approach was performed on five cadaveric heads using microsurgical and endoscopic techniques. Target points were defined in the lateral ventricle, and quantitative analysis was performed to assess limits of exposure within the lateral ventricle. Two coronal reference planes corresponding to the anterior and posterior margins of the lateral ventricle body were defined. Distances from target points to reference planes were measured, and an imaging-based predicting system was provided according to obtained measurements to guide preoperative approach selection. Results: Mean (standard deviation) distances between the predefined target points indicating the anterior limits and the anterior plane were 9 (7.0) mm, 11 (5.8) mm, and 7 (5.1) mm; posterior limits had distances of 8 (3.0) mm, 17 (9.2) mm, 15 (9.2) mm, and 9 (7.2) mm to the posterior plane. Limiting factors of the choroidal fissure dissection were the venous angle anteriorly and thalamocaudate vein posteriorly. The position of the venous angle had a high negative correlation with the anterior exposure limit ( = -0.87, < 0.001; = -0.92, < 0.001). Conclusion: A step-by-step anatomical description of a new SIIS approach is given, and a quantitative description of the limits of the exposure is provided to evaluate the application of this approach.

Publication Date

2-19-2021

Publication Title

Surgical neurology international

ISSN

2229-5097

Volume

12

First Page

39

PubMed ID

33598355

Digital Object Identifier (DOI)

10.25259/SNI_909_2020

Recommended Citation

Abramov, Irakliy; Zhao, Xiaochun; Belykh, Evgenii; Lawton, Michael T.; Pitskhelauri, David; and Preul, Mark C., "Supracerebellar infratentorial inverted subchoroidal approach to lateral ventricle lesions: Anatomical study and illustrative case" (2021). Neurosurgery. 1415.
https://scholar.barrowneuro.org/neurosurgery/1415