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Suboccipital Median Approach

  • Rüdiger Gerlach
  • Volker Seifert

Abstract

After orotracheal intubation of the patient, a central line is inserted usually via the right internal jugular or subclavian vein with the tip position just before (lateral and prone positions) or within the right atrium (semisitting position, SSP). Invasive blood pressure monitoring is performed throughout the entire procedure via a radial artery line. Routine monitoring includes electrocardiography, pulse oxymetry, invasive arterial blood pressure, and urine output. Indications for intraoperative electrophysiological monitoring (IOM) are large cerebellar lesions extending towards the pineal region as well as lesions close to or infiltrating the fourth ventricle or the medulla oblongata. IOM consists of standard somatosensory, motor, and brainstem auditory evoked potentials and cranial nerve monitoring. Direct intraoperative stimulation is performed during resection of lesions of the floor of the fourth ventricle.

Keywords

Fourth Ventricle Posterior Inferior Cerebellar Artery Transverse Sinus Pineal Region Posterior Arch 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Jadik S, Wissing H, Friedrich K et al (2009) A standardized protocol for the prevention of clinically relevant venous air embolism during neurosurgical interventions in the semisitting position. Neurosurgery 64(3):533–538; discussion 538–539CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2010

Authors and Affiliations

  • Rüdiger Gerlach
    • 1
  • Volker Seifert
    • 1
  1. 1.Dept of NeurosurgeryJohann Wolfgang Goethe UniversityFrankfurt am MainGermany

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