Median supracerebellar infratentorial approach

Median supracerebellar infratentorial approach for posterior mesencephalic pathology. (a) Using the prone position with the head flexed, a cadaveric dissection demonstrates the linear medial incision from just above the external occipital protuberance down to the spinous process of the axis. The craniotomy should carefully expose the torcula and both transverse sinuses, allowing a wide operative view between the cerebellum and tentorium.

The vein of Galen, internal cerebral veins, and basal veins of Rosenthal occupy most of the field between the tentorium and anterior vermis, making the safe dissection and caudal exposure of the quadrigeminal plate challenging.

See above

This microdissection reveals the safe entry zones on the tectum, namely the