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Pineal Region Tumor (Occipital Transtentorial Approach)

Last Updated: September 30, 2018

For general considerations, diagnosis and evaluation, indications for surgery, and preoperative considerations, please refer to the Pineal Region Tumor (Infratentorial Supracerebellar Approach) chapter.

For the occipital transtentorial route, preoperative magnetic resonance venogram or computed tomography venogram may be considered to locate the bridging veins in the parasagittal occipital region.

The occipital transtentorial approach enters the cranial vault through a unilateral occipital craniotomy. This approach offers wide exposure of the quadrigeminal plate and is particularly useful for large pineal region tumors that extend laterally and inferiorly. This approach is especially favorable for reaching lesions arising from the precentral cerebellar fissure, posterior incisural space,...