Posterior Interhemispheric Transcallosal Approach to Pineal Region Tumors

Abstract

Introduction Pineal region tumors pose one of the most formidable technical challenges to neurosurgeons due to their deep location association with critical vascular structures and potential for significant surgical morbidity. The posterior interhemispheric transcallosal approach provides a direct surgical corridor to the pineal region with access from the third ventricle to the quadrigeminal cistern while affording direct visualization and control of critical anatomical and vascular structures. Details of this approach and its specific indications are presented along with the early results on eight patients. In addition a brief comparison to other surgical approaches by the authors in 32 other pineal region tumors is reviewed. Methods Two pineoblastomas, two papillary tumors of the pineal, one pineocytoma, one mixed malignant germ cell tumor, one choroid plexus carcinoma, and one mature teratoma were successfully approached in eight patients. A right parasagittal posterior parietal craniotomy was perform...