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Journal of Korean Neurosurgical Society > Volume 21(8); 1992 > Article
Journal of Korean Neurosurgical Society 1992;21(8): 1018-1025.
Occipital Transtentorial Approach to Pineal Region.
I B Yang, Y T Jung, B O Choi, S C Kim, J H Sim
Department of Neurosurgery, College of Medicine, Inje University, Paik Hospital, Pusan, Korea.
Tumors arising from pineal gland and surrounding regions lie in a central portion of the brain and are difficult to expose for operative removal. They often involve the deep venous system of the brain, which adds to the hazard of operation. Numerous authors have reported the successful surgical management of lesions in pineal region. There are basically two approaches to this region that are in common use:the infratentorial supracerebellar approach described by Krause and Stein and the occipital transtentorial approach described by Poppen and Jamieson. This paper reports experience occipital transtentorial approach in the treatment of 5 patients with pineal tumor and 2 patients with arteriovenous malformation in this area. The postoperative result were good in 5, fair in 1 and died in 1 case. The cause of death is recurrence of tumor. We believe that the occipital transtentorial approach for pineal region under surgical microscope is a safe technique because of the broader range of exposure above the tentorial notch, the rare need to sacrifice normal vascular or nervous tissues, less difficulty in patient positioning, and greater comfort for the surgeon while operating.
Key Words: Pineal region; Tumor; Arteriovenous malformation; Occipital transtentorial; Infratentorial supracerebellar
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