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Midline Suboccipital Approach and Its Variations for Fourth Ventricular or Cerebellar Hemispheric Lesions

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Microsurgical Anatomy and Surgery of the Posterior Cranial Fossa

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Abstract

In this chapter, the basic techniques involved in the midline suboccipital approach and its variations are explained, focusing on intracranial lesion exposure, patient positioning, and bony opening sites. The midline suboccipital approach varies from case to case: the range of bony openings is altered up and down or left and right, depending on the lesion location. To approach lesions in the fourth ventricle and cerebellar hemisphere accurately, exposure of the vermian and/or cerebellar hemispheric surfaces must be considered when selecting patient positioning and bony opening site [13, 15]. Furthermore, preoperative interpretation of lesion location is vital [6, 10].

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References

  1. Inoue T, Matsushima T, Inamura T, Kawamura T, Ishihara S, Fukui M (1998) Surgical approach to the mesencephalic vascular malformation. Surg Cerebr Stroke 26:287–291 (in Japanese)

    Article  Google Scholar 

  2. Kellogg JX, Piatt JH Jr (1997) Resection of fourth ventricle tumors without splitting the vermis: the cerebellomedullary fissure approach. Pediatr Neurosurg 27:28–33

    Article  CAS  PubMed  Google Scholar 

  3. Kobayashi S, Sugita K, Tanaka Y, Kyoshima K (1983) Infratentorial approach to the pineal region in the prone position: concorde position. J Neurosurg 58:141–143

    Article  CAS  PubMed  Google Scholar 

  4. Matsushima T (2006) Microsurgical Anatomy and Surgery of the Posterior Fossa. SciMed Publications, Tokyo (in Japanese)

    Google Scholar 

  5. Matsushima T, Fukui M (1996) Lateral approach to the foramen magnum: with special reference to the transcondylar fossa approach and the transcondylar approach. Neurol Surg 24:119–124 (in Japanese)

    CAS  Google Scholar 

  6. Matsushima T, Fukui M, Inoue T, Natori Y, Baba T, Fujii K (1992) Microsurgical and magnetic resonance imaging anatomy of the cerebello-medullary fissure and its application during fourth ventricle surgery. Neurosurgery 30:325–330

    Article  CAS  PubMed  Google Scholar 

  7. Matsushima T, Fukui M, Rhoton AL Jr (1989) Microsurgical Anatomy of the Fourth Ventricle-Special reference to the Suboccipital Midline Approach-Surgical Anatomy for Microneurosurgery I. SciMed Publications Inc., Tokyo, pp 200–211 (in Japanese)

    Google Scholar 

  8. Matsushima T, Hitotsumatsu T, Fukui M, Rhoton AL Jr (1997) Surgical treatment of lesions in and around the fourth ventricle - Part 1: Microsurgical anatomy for midline suboccipital approach to lesions in or around the fourth ventricle: special reference to the neural structure. Nerv Syst Child 22:241–247 (in Japanese)

    Google Scholar 

  9. Matsushima T, Ikezaki K, Inoue T, Fukui M (1998) Surgery of ependymomas within or Adjacent to the fourth ventricle. Surgery of Gliomas. MEDICUS SHUPPAN Publisher, Osaka, pp 54–61 (in Japanese)

    Google Scholar 

  10. Matsushima T, Ikezaki K, Mihara F, Fukui M (1998) Surgical treatment of lesions in and around the fourth ventricle - Part 3: Special reference to pre-surgical anatomical MRI. Nerv Syst Child 23:279–291 (in Japanese)

    Google Scholar 

  11. Matsushima T, Inoue T, Inamura T, Natori Y, Ikezaki K, Fukui M (2001) Transcerebello-medullary fissure approach to the fourth ventricle─Special reference to the opening methods of the fissure. J Neurosurg 94:257–264

    Article  CAS  PubMed  Google Scholar 

  12. Matsushima T, Kawashima M, Masuoka J, Mineta T, Inoue T (2010) Transcondylar fossa (supracondylar trans-jugular tubercle) approach: Anatomic basis for the approach, surgical procedures, and surgical experience. Skull Base 20:83–91

    Article  PubMed  PubMed Central  Google Scholar 

  13. Matsushima T, Matsukado K, Inamura T, Natori Y, Inoue T, Ikezaki K, Fukui H (2000) Approach to the Fourth Ventricle: Midline Suboccipital Approach –Special reference to Trans-cerebellomedullary Fissure Approach. Surgical Anatomy for Microneurosurgery XII. SciMed Publications Inc, Tokyo, pp 99–110 (in Japanese)

    Google Scholar 

  14. Matsushima T, Matsukado K, Inoue T, Fukui M (2000) Surgical treatment of lesions in and around the fourth ventricle - Part 5: Trans-cerebellomedullary fissure approach. Nerv Syst Child 25–3:173–177 (in Japanese)

    Google Scholar 

  15. Matsushima T, Matsukado K, Rhoton AL Jr (2002) Microsurgical Anatomy for the Midline Suboccipital Approach. Surgical Anatomy for Microneurosurgery XIV. SciMed Publications Inc, Tokyo, pp 179–188 (in Japanese)

    Google Scholar 

  16. Matsushima T, Rhoton AL Jr, Lenkey C (1982) Microsurgery of the fourth ventricle: part 1: Microsurgical anatomy. Neurosurgery 11:631–667

    Article  CAS  PubMed  Google Scholar 

  17. Matsushima T, Rhoton AL Jr, Oliveira E, Peace D (1983) Microsurgical anatomy of the posterior fossa. J Neurosurg 59:63–105

    Article  CAS  PubMed  Google Scholar 

  18. Matsutani M (1998) 2. Midline approach. Anatomy for Neurological Surgery. Medical View, Tokyo, pp 74–76 (in Japanese)

    Google Scholar 

  19. Tsukamoto H, Matsushima T, Shono S, Miyazono M, Fukui M, Kondo A (1992) Primary yolk sac tumor of the cerebellar vermis: case report. Surg Neurol 38:50–56

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery Faculty of Medicine, Saga University, Saga, Japan

    Toshio Matsushima

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  1. Toshio Matsushima
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Matsushima, T. (2015). Midline Suboccipital Approach and Its Variations for Fourth Ventricular or Cerebellar Hemispheric Lesions. In: Microsurgical Anatomy and Surgery of the Posterior Cranial Fossa. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54183-7_6

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  • DOI: https://doi.org/10.1007/978-4-431-54183-7_6

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  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-54182-0

  • Online ISBN: 978-4-431-54183-7

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