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Öğe In Reply: Opening the Parieto-Occipital Fissure for Periatrial Metastasis: 2-Dimensional Operative Video(Lippincott Williams & Wilkins, 2024) Dogruel, Yucel; Rahmanov, Serdar; Gungor, Abuzer; Ture, Ugur[Abstract Not Available]Öğe Microsurgical Resection of a Parachiasmatic Craniopharyngioma via a Left-Sided Pterional Transsylvian Approach(Elsevier Science Inc, 2024) Dogruel, Yucel; Rahmanov, Serdar; Gungor, Abuzer; Ture, UgurCraniopharyngiomas are histologically benign tumors that originate from squamous rests along the pituitary stalk. They make up approximately 1.2% to 4.6% of all intracranial tumors and do not show significant differences in occurrence based on sex. Adamantinomatous craniopharyngiomas have 2 peaks of incidence, commonly observed in patients from ages 5 to 15 years and again from 45 to 60 years. In contrast, papillary craniopharyngiomas mainly affect adults in their fifth and sixth decades of life.1 The malignancy of craniopharyngiomas is attributed to their location and the challenges associated with achieving complete removal because they can manifest in the sellar, parachiasmatic, and intraventricular regions or a combination of these.2,3 Various approaches have been used to resect these tumors.4,5 Radical resection offers the most promising option for disease control, potential cure, and the ability to transform the disease from lethal to survivable in children, allowing for a functional adult life.2,3 Meticulous evaluation is crucial to determine the appropriate approach and side, with particular emphasis on closely examining the relationship between the tumor and optic pathways (nerve, chiasm, tract), which are frequently involved. This assessment should also include the tumor's relationship with other crucial structures, such as the hypothalamus and adjacent arteries, to ensure that the strategy is adjusted accordingly to further minimize the risk of postoperative morbidity. Video 1 demonstrates a left -sided pterional transsylvian approach to remove a parachiasmatic craniopharyngioma involving the left optic chiasm and tract.Öğe Opening the Parieto-Occipital Fissure for Periatrial Metastasis: 2-Dimensional Operative Video(Lippincott Williams & Wilkins, 2024) Dogruel, Yucel; Rahmanov, Serdar; Gungor, Abuzer; Ture, Ugur[Abstract Not Available]Öğe Posterior Interhemispheric Transtentorial Subsplenial Approach for Posterior Thalamic Tumors: 2-Dimensional Operative Video(Lippincott Williams & Wilkins, 2024) Dogruel, Yuecel; Rahmanov, Serdar; Gungor, Abuzer; Ture, UgurINDICATIONS: CORRIDOR AND LIMITS OF EXPOSURE:The posterior interhemispheric transtentorial subsplenial approach provides a direct corridor to posterior thalamic lesions without a cortical or callosal incision.1 ANATOMIC ESSENTIALS: NEED FOR PREOPERATIVE PLANNING AND ASSESSMENT:This corridor is through the posterior interhemispheric fissure along the medial surface of the cuneus and allows the subsplenial region to be explored. Evaluating the tumor's size and extension is crucial to determining the suitability of this approach. The deep venous system may be displaced from mass effect, requiring preoperative venous examination. ESSENTIALS STEPS OF THE PROCEDURE:A 34-year-old male patient was admitted elsewhere with blurred vision and imbalance. MRI revealed a right-sided posterior thalamic tumor with heterogeneous contrast enhancement. The patient was followed-up after placement of a ventriculoperitoneal shunt. Seven months later, he was admitted to our clinic because the tumor had grown. The patient underwent surgical intervention. The patient was placed in the prone oblique position. After dural opening, the quadrigeminal cistern was opened to release cerebrospinal fluid, allowing significant gravity relaxation of the ipsilateral hemisphere. The tentorium was cut and retracted to achieve the necessary exposure. PITFALLS/AVOIDANCE OF COMPLICATIONS:The most serious complications of this approach occur from vascular injuries. Gravitational retraction of the occipital lobe protects the optic radiation, and anatomic landmarks help the surgeon maintain anatomic orientation. VARIANTS AND INDICATIONS FOR THEIR USE:The perimedian supracerebellar transtentorial approach is an alternative to the posterior interhemispheric transtentorial subsplenial approach for lesions in this area; however, the indications and limits of these approaches have some differences.The patient consented to the procedure and to the publication of his/her image.Images at 0:29 reused from Serra et al,1 with permission from Elsevier. VARIANTS AND INDICATIONS FOR THEIR USE:The perimedian supracerebellar transtentorial approach is an alternative to the posterior interhemispheric transtentorial subsplenial approach for lesions in this area; however, the indications and limits of these approaches have some differences.The patient consented to the procedure and to the publication of his/her image.Images at 0:29 reused from Serra et al,1 with permission from Elsevier. VARIANTS AND INDICATIONS FOR THEIR USE:The perimedian supracerebellar transtentorial approach is an alternative to the posterior interhemispheric transtentorial subsplenial approach for lesions in this area; however, the indications and limits of these approaches have some differences.The patient consented to the procedure and to the publication of his/her image.Images at 0:29 reused from Serra et al,1 with permission from Elsevier.