PARAMEDIAN SUPRACEREBELLAR APPROACH TO THE UPPER BRAIN-STEM AND PEDUNCULAR LESIONS

OBJECTIVE: The infratentorial paramedian supracerebellar approach is u seful for lesions involving the upper brain stem or the cerebellar ped unculi. We provide a precise description of this approach and its indi cations. METHODS: Four patients were operated on using this approach. The lesions included a squamous cell carcinoma, a glioblastoma multifo rme, a hematoma, and a cavernoma. The lesions involved the quadrigemin al plate, the superior cerebellar peduncle, the middle cerebellar pedu ncle, and the quadrangular lobule of the cerebellum RESULTS: Postopera tively, there was no apparent aggravation of neurological symptoms. Th e main advantage of the approach was that the operation can be perform ed with a wide horizontal view without sacrificing the deep veins. CON CLUSIONS: It is concluded that lesions in the superior and inferior co lliculus, superior and middle cerebellar peduncles, and quadrangular l obules of the cerebellum can be safely operated on with this approach.