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Transtentorial Approach to Parahippocampal Lesions

Last Updated: February 19, 2019

Supracerebellar Transtentorial Approach for Resection of a Posterior Parahippocampal Tumor

General Considerations

Operative access to the posterior medial temporal lobe and parahippocampal regions is challenging because of the overlying vital cortices and unavailability of safe skull base corridors.

Subtemporal, transtemporal, transsylvian/transinsular/transcisternal, and potential interhemispheric parieto-occipital approaches have been considered reasonable trajectories to the region. The subtemporal approach requires excessive temporal lobe retraction with an associated risk to the vein of Labbé. The transtemporal approach transgresses the posterior temporal neocortex, a vital territory on the dominant side; it also leads to disruption of the optic radiations. The transsylvian-trans...