Transsphenoidal Approach
18 Transsphenoidal ApproachEdward R. Laws Jr., Paul T. Boulos, and John Jane Jr. Indications Macroadenomas (tumors ≥ 1 cm) Microadenomas causing Cushing disease or acromegaly Medically refractory or unresponsive prolactin…
Occipital and Transtentorial Approaches
17 Occipital and Transtentorial ApproachesOmar N. Syed, Ricardo J. Komotar, and Jeffrey N. Bruce Indication Mass lesions of the occipital lobe Posterior falcine meningiomas Tentorial meningiomas with only supratentorial component…
Reoperative Craniotomy Considerations
19 Reoperative Craniotomy ConsiderationsKevin Walter Indications Recurrent or progressive pathology Tumor growth Vascular malformation (aneurysm, arteriovenous malformation, cavernoma) Staged operation Large tumor Seizure surgery (mapping and resection) Intracranial hemorrhage Reconstruction/remodeling…
Temporal Approach
12 Temporal ApproachRobert R. Goodman Indications Temporal lobectomy for epilepsy Tumors and vascular malformations of the lateral and medial temporal lobe Temporal lobe open brain biopsy Evacuation of temporal lobe…
Retrosigmoid Approach (Vestibular Schwannomas)
14 Retrosigmoid Approach(Vestibular Schwannomas)Michael B. Sisti Indications Progressive hearing loss or recent, worsening symptoms Brain stem compression Observed tumor enlargement in a relatively low-risk operative candidate Tumor growth despite radiosurgery…
Subtemporal Approach
11 Subtemporal ApproachChristopher E. Mandigo and Jeffrey N. Bruce Indications Petroclival tumors Large, giant, or complex basilar apex aneurysms Posterior cerebral artery aneurysms Superior cerebellar basilar artery aneurysms Anteromedial tentorial…
Presigmoid Approach
13 Presigmoid ApproachDavid Gordon and Chandranath Sen Indications Approach to posterior fossa from the level of midbrain to jugular bulb Approach to lesions involving or in proximity to the posterior…
Transcallosal Approach
10 Transcallosal ApproachMichael B. Sisti Indications Tumors of the third ventricle Lesions of the lateral ventricles Corpus callosotomy ♦ Preoperative Operative Planning Review imaging (magnetic resonance imaging [MRI]) Equipment Major…
Superior Parietal Lobule Approach
8 Superior Parietal Lobule ApproachJeffrey N. Bruce Indications Lesions of parietal lobe Dorsal posterior thalamic tumors Posterior lateral ventricular lesions ♦ Preoperative Operative Planning Review imaging: magnetic resonance imaging (MRI)…
Convexity and Parasagittal Approaches
9 Convexity and Parasagittal ApproachesJeffrey N. Bruce ♦ Preoperative Operative Planning Review imaging (magnetic resonance imaging ± contrast with magnetic resonance venogram to evaluate draining vein pattern and sinus patency;…
