Transcollicular Approach to Intrinsic Tectal Lesions

Transcollicular Approach to Intrinsic Tectal Lesions AbstractOBJECTIVE:We used a paramedian, infratentorial-supracerebellar, transcollicular approach to resect 11 intrinsic tectal lesions, including 8 tumors and 3 hematomas, in 11 patients. The route of access to the lesions was designed to minimize the anatomic and functional damage to the surrounding structures.METHODS:Access was through one superior colliculus in each of seven patients, through one inferior colliculus in each of two patients, and through the superior and inferior colliculi of one side in each of two patients.RESULTS:Of the eight tumors, three were totally resected, four were nearly totally resected, and one was partially resected. The preoperative ocular symptoms did not change in six of these eight patients and worsened in two, and the neurological deficits, except ocular symptoms, improved in two. All three hematomas were completely removed, along with abnormal blood vessels in the wall of the hematoma cavity; all three of these patients experienced neurological improvement.CONCLUSION:We conclude that the paramedian, infratentorial-supracerebellar, transcollicular approach permits safe removal of intrinsic tectal lesions. Resection of the superior or inferior colliculus or both on one side seems to be neurologically well tolerated. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Transcollicular Approach to Intrinsic Tectal Lesions

Transcollicular Approach to Intrinsic Tectal Lesions

TECHNIQUE AND ASSESSMENTS Yasuhiko Kaku, M .D ., Yasuhiro Yonekawa, M .D ., Ethan Taub, M .D. Department of Neurosurgery, U niversity Hospital of Z u ric h , Z u rich , Sw itzerland O B JE C T IV E : W e used a paramedian, infratentorial-supracerebellar, transcollicular approach to resect 11 intrinsic tectal lesions, including 8 tumors and 3 hematomas, in 11 patients. The route of access to the lesions was designed to minimize the anatomic and functional damage to the surrounding structures. M E T H O D S : Access was through one superior colliculus in each of seven patients, through one inferior colliculus in each of two patients, and through the superior and inferior colliculi of one side in each of two patients. RESULTS: O f the eight tumors, three were totally resected, four w ere nearly totally resected, and one was partially resected. The preoperative ocular symptoms did not change in six of these eight patients and worsened in two, ' and the neurological deficits, except ocular symptoms, improved in two. All three hematomas w ere completely removed, along with abnormal blood vessels in the w all of the hematoma cavity; all three of these patients experienced neurological improvement. f C O N C L U S IO N : W e conclude that the paramedian, infratentorial-supracerebellar, transcollicular approach permits safe removal of intrinsic tectal lesions. Resection of the superior or inferior colliculus or both on one side seems to be neurologically well tolerated. (Neurosurgery 4 4 :3 3 8 -3 4 4 , 1999) Key words: Inferior c o llic u lu s, M idbrain, Superior c o llic u lu s, Surgical approach, Tectum T he operative treatment of intrinsic tectal lesions remains unilateral trochlear nerve paresis, two of oculomotor nene 3 a major challenge. Recent advances in neuroimaging paresis (one unilateral and one bilateral), and one of unilateral and in microsurgical technique have made such opera­ internuclear ophthalmoplegia. Four patients had sy m p to m s l tions...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199902000-00052
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:We used a paramedian, infratentorial-supracerebellar, transcollicular approach to resect 11 intrinsic tectal lesions, including 8 tumors and 3 hematomas, in 11 patients. The route of access to the lesions was designed to minimize the anatomic and functional damage to the surrounding structures.METHODS:Access was through one superior colliculus in each of seven patients, through one inferior colliculus in each of two patients, and through the superior and inferior colliculi of one side in each of two patients.RESULTS:Of the eight tumors, three were totally resected, four were nearly totally resected, and one was partially resected. The preoperative ocular symptoms did not change in six of these eight patients and worsened in two, and the neurological deficits, except ocular symptoms, improved in two. All three hematomas were completely removed, along with abnormal blood vessels in the wall of the hematoma cavity; all three of these patients experienced neurological improvement.CONCLUSION:We conclude that the paramedian, infratentorial-supracerebellar, transcollicular approach permits safe removal of intrinsic tectal lesions. Resection of the superior or inferior colliculus or both on one side seems to be neurologically well tolerated.

Journal

NeurosurgeryOxford University Press

Published: Feb 1, 1999

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