Artículos de revistas
Combined pre- and subtemporal transtentorial approach for epidermoid cysts of the cerebellopontine angle
Fecha
2013-08-02Registro en:
CHILDS NERVOUS SYSTEM, NEW YORK, v. 28, n. 12, supl. 1, Part 2, pp. 2137-2142, DEC, 2012
0256-7040
10.1007/s00381-012-1904-8
Autor
de Oliveira, Ricardo Santos
Maia, Werllen Soares
Santos, Marcelo Volpon
Brandao Camara, Rodio Luis
Institución
Resumen
Objective Epidermoid cysts of the cerebellopontine angle (CPA) can be a surgical challenge for the pediatric neurosurgeon. Ideally, total removal must be achieved; however, occasional adhesions of these tumors to vital neurovascular structures and extension far beyond the midline may preclude their total removal. The aims of this article are to present an alternative surgical approach to these lesions and to provide the rationale for this technique. Material and methods A 16-year-old boy was admitted to our pediatric neurosurgery department with a 1-year history of nonspecific headaches. His neurological examination showed right-sided dysmetria and gait ataxia. Magnetic resonance scans showed a space-occupying lesion on the right CPA with low intensity on T-1-weighted images and high intensity on T-2-weighted images. Results Craniotomy for tumor excision via pre- and subtemporal transtentorial approach was performed disclosing a 3.5 x 3 x 2.8-cm(3) well-encapsulated tumor, which was confirmed to be an epidermoid cyst. The postoperative course was uneventful. Conclusions A combined pre- and subtemporal approach utilizes a wide opening of the tentorium and the option of supratentorial retraction of the cerebellum to provide an excellent angle of approach to CPA lesions involving the anterolateral aspect of the brain stem in children.