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Selection of Operative Corridor

Last Updated: September 30, 2018

Figure 1: The man in this photograph, a patient of Harvey Cushing’s, suffered from Parinaud’s syndrome and died before a diagnosis and tumor localization was made. The autopsy specimen (right photo) demonstrates a tumor located in the pineal region (images courtesy of Cushing Brain Tumor Registry at Yale University).

The pineal region is located deep within the center of the cranial vault and consists of the pineal gland and adjacent structures. Although there are no clear-cut boundaries for the pineal region, it is surrounded superiorly by the splenium of the corpus callosum, posteriorly by the vein of Galen, inferiorly by the quadrigeminal cistern and tectum, and anteriorly by the pineal recess and the posterior third ventricle.

Each of these structures can be subject to mass effect...