OCCIPITOTRANSTENTORIAL APPROACH FOR LESIONS OF THE SUPERIOR CEREBELLAR HEMISPHERE - TECHNICAL REPORT

OBJECTIVE: The occipitotranstentorial approach is well accepted for le sions of the pineal region, superior cerebellar vermis, or mesencephal on. Although evidently suitable, this approach has not, to our knowled ge, been reported for lesions of the superior cerebellar hemisphere in adults. Experience with this approach is reported, METHODS: Four pati ents underwent surgery between August 1995 and March 1997. The finding s obtained are evaluated. RESULTS: All lesions were situated in the qu adrangular lobules (one extending into the vermis), and all were compl etely removed. Postoperative deficits, especially visual field deficit s, did not occur. CONCLUSION: Lesions of the superior cerebellar hemis pheres are easily approached by an occipitotransfentorial route. The m ajor advantages over a supracerebellar approach are that the surgical route is nearly perpendicular to the lesion and to the tentorium inste ad of parallel, and a wider exposure is thereby possible.