전방상소뇌 종양에 대한 후두경천막접근법

Occipital Transtentorial Approach to the Anterosuperior cerebellar Tumors

Objectives : To minimize the retraction of the cerebellum and access the feeding artery directly, we used the occipital transtentorial approach for the anterosuperior cerebellar tumors. Here, we describe the surgical technique and the advantage of occipital transtentorial approach for anterosuperior cerebellar tumors. Methods : From January 1999 to December 2007, we performed the occipital transtentorial approach for 3 patients with infratentorial tumors: one cerebellar hemangioblastoma, one metastatic cerebellar tumor, and one transtentorial meningioma. All tumors were located at anterosuperior cerebellum. Digital subtraction angiography was performed to hemangioblastoma patient. We routinely checked visual acuity and visual field postoperatively. Results : All tumors were removed totally. One patient had transtentoiral meningioma showed transient hemianopsia postoperatively but improved spontaneously. There was no severe morbidity and mortality. Conclusions : Despite of the limited experience, occipital transtentorial approach is a useful surgical strategy for the removal of tumors located at the anterosuperior cerebellar tumors. To prevent the neurologic complication, excessive occipital lobe retraction should be avoided.