The lateral supracerebellar infratentorial, translateral mesencephalic sulcus approach to the mesencephalopontine junction

Authors

M Yashar Kalani, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.Follow
Kaan Yağmurlu, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Nikolay L. Martirosyan, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.Follow
Robert F. Spetzler, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Document Type

Article

Abstract

The lateral supracerebellar infratentorial (SCIT) approach provides advantageous access to lesions located in the lateral mesencephalon and mesencephalopontine junction. For lesions that abut the pial surface, a direct approach is ideal and well tolerated. For deep-seated lesions, the lateral mesencephalic sulcus (LMS) can be used to access lesions with minimal morbidity to the patient. This video demonstrates the use of the SCIT approach via the LMS to remove a cavernous malformation at the level of the mesencephalopontine junction. The use of somatosensory and motor evoked potential monitoring and intraoperative neuronavigation is essential for optimizing patient outcomes. Meticulous, multilayered closure is critical for optimal results in the posterior fossa. For optimal patient outcomes, approach selection for deep-seated lesions should combine the two-point method with safe entry zones. At follow-up, the patient had persistent sensory changes but was otherwise neurologically intact. The video can be found here: https://youtu.be/bHFEZhG8dHw.

Publication Date

10-1-2019

Publication Title

Neurosurgical focus: Video

E-ISSN

2643-5217

Volume

1

Issue

2

First Page

V14

PubMed ID

36284868

Digital Object Identifier (DOI)

10.3171/2019.10.FocusVid.19454

Recommended Citation

Kalani, M Yashar; Yağmurlu, Kaan; Martirosyan, Nikolay L.; and Spetzler, Robert F., "The lateral supracerebellar infratentorial, translateral mesencephalic sulcus approach to the mesencephalopontine junction" (2019). Neurosurgery. 1722.
https://scholar.barrowneuro.org/neurosurgery/1722