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How I do it—pineal surgery: supracerebellar infratentorial versus occipital transtentorial

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Abstract

Background

Resection of a pineal tumour requires fastidious pre-operative planning to select the optimal surgical approach and maximise resection while minimising morbidity.

Method

To describe and compare the supracerebellar infratentorial and occipital transtentorial approaches.

Conclusions

Specific considerations include patient-specific anatomy, extent and relationships of the tumour, and the techniques likely to be employed during resection. The supracerebellar infratentorial approach provides a direct corridor to pineal tumours caudal to the deep veins; for tumours invaginating the tectal plate in a caudal direction the occipital transtentorial provides a better view.

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References

  1. British Neuro-Oncology Society/NCAT rare tumour guidelines (2011). Guidelines on the Diagnosis and Management of Adult Pineal Area Tumours. http://www.bnos.org.uk/documents/rare_tumours_guidelines/Pineal%20guidelines.pdf. Accessed on 21 September 2012

  2. Bruce JN, Stein BM (1995) Surgical management of pineal region tumors. Acta Neurochir (Wien) 134:130–135

    Article  CAS  Google Scholar 

  3. Bruce JN (2011) Pineal tumors. In: Winn HR (ed) Youmans Neurological surgery, 6th edn. Elsevier, Philadelphia, pp 1359–1372

  4. Hernesniemi J, Romani R, Albayrak BS, Lehto H, Dashti R, Ramsey C 3rd, Karatas A, Cardia A, Navratil O, Piipo A, Fujiki M, Toninelli S, Niemela M (2008) Microsurgical management of pineal region lesions: personal experience with 119 patients. Surg Neurol 70:576–583

    Article  PubMed  Google Scholar 

  5. Jamieson KG (1971) Excision of pineal tumors. J Neurosurg 35:550–553

    Article  PubMed  CAS  Google Scholar 

  6. Lang J (1979) Praktische Anatomie. Kopf Teil B, Gehrin- und Augenschadel. Springer, Berlin

    Google Scholar 

  7. Little KM, Friedman AH, Fukushima T (2001) Surgical approaches to pineal region tumours. J Neurooncol 54:287–299

    Article  PubMed  CAS  Google Scholar 

  8. Oppenheim H, Krause F (1913) Operative erfolge bei geschwulsten der sehhugel- und vierhugelgegent. Berl Klin Wochenschr 50:2116–2322

    Google Scholar 

  9. Santoro G, Wood MD, Merlo L, Anastasis GP, Tomasello F, Germano A (2009) The anatomic location of the soul from the body, through the brain, to the whole body, and beyond: a journey through western history, science and philosophy. Neurosurgery 65:633–643

    Article  PubMed  Google Scholar 

  10. Sano K (2000) Alternate surgical approaches to pineal regions neoplasms. In: Schmidek HB, Sweet W (eds) Operative neurosurgical techniques: indications, methods and results. Saunders, New York, pp 895–907

  11. Tamaki N, Fujiwara Km Matumoto S, Takeda H (1973) Veins draining the pineal body: an anatomical and neuroradiological study of “pineal veins”. J Neurosurg 39:448–454

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Michael G. Hart.

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Hart, M.G., Santarius, T. & Kirollos, R.W. How I do it—pineal surgery: supracerebellar infratentorial versus occipital transtentorial. Acta Neurochir 155, 463–467 (2013). https://doi.org/10.1007/s00701-012-1589-5

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  • DOI: https://doi.org/10.1007/s00701-012-1589-5

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