Lt suboccipital supracerebellar transtentorial approach for resect. of tectal cavernous malformation
1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and 2Department of Neurosurgery, Hofstra Northwell School of Medicine, Manhasset, New York A 64-year-old man with a midbrain cavernoma and prior bleeding presented with a 1-week history of diplopia, partial left oculomotor nerve palsy, and worsening dysmetria and right-sided weakness. MRI revealed a hemorrhagic left tectal plate and midbrain cavernoma. A left suboccipital supracerebellar transtentorial approach in the sitting position was performed for resection of his lesion utilizing the lateral mesencephalic sulcus safe entry zone. Postoperatively, he developed a partial right oculomotor nerve palsy; imaging depicted complete resection of the cavernoma. He recovered from the right third nerve palsy, weakness, and dysmetria, with significant improvement of his partial left third nerve palsy. **Intro music: "Daybreak" by Graeme Rosner
