Experience with the infratentorial supracerebellar approach in lesions of the quadrigeminal region, posterior third ventricle, culmen cerebelli, and cerebellar peduncle.

We report about our experience with the infratentorial supracerebellar approach in 23 patients operated on for lesions located in the posterior part of the third ventricle, quadrigeminal plate, culmen cerebelli and cerebellar peduncle. Three patients had transient worsening of their deficits immediately after surgery. Three patients developed haemorrhages postoperatively requiring surgical evacuation. One of them died. None of the patients developed specific complications which could without any doubt be attributed to the approach. We concluded that in combination with intra-operative CSF drainage and the sitting position the infratentorial supracerebellar approach allows safe access to lesions situated in an area limited by the posterior part of the third ventricle, the fastigium level and both cerebellar peduncles.