Clip retraction of the tentorium: application of a novel technique for tentorial retraction during supracerebellar transtentorial approaches.

Abstract:

:Supracerebellar transtentorial (SCTT) approaches have become a popular option for treatment of a variety of pathologies in the medial and basal temporal and occipital lobes and thalamus. Transtentorial approaches provide numerous advantages over transcortical approaches, including obviating the need to traverse eloquent cortex, not requiring parenchymal retraction, and circumventing critical vascular structures. All of these approaches require a tentorial opening, and numerous techniques for retraction of the incised tentorium have been described, including sutures, fixed retractors, and electrocautery. However, all of these techniques have considerable drawbacks and limitations. The authors describe a novel application of clip retraction of the tentorium to the supracerebellar approaches in which an aneurysm clip is used to suspend the tentorial flap, and an illustrative case is provided. Clip retraction of the tentorium is an efficient, straightforward adaptation of an established technique, typically used for subtemporal approaches, that improves visualization and surgical ergonomics with little risk to nearby venous structures. The authors find this technique particularly useful for the contralateral SCTT approaches.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Baranoski JF,Bajaj A,Przybylowski CJ,Catapano JS,Frisoli FA,Lang MJ,Lawton MT

doi

10.3171/2020.2.JNS192952

subject

Has Abstract

pub_date

2020-04-24 00:00:00

pages

1-5

eissn

0022-3085

issn

1933-0693

pii

2020.2.JNS192952

pub_type

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