Resection of arteriovenous malformation in the middle cerebellar peduncle by a posterior transpetrosal approach: illustration of a case and correlative microsurgical anatomy.

Background: Lesions located in the posterolateral brain stem, particularly the middle cerebellar peduncle, have presented surgeons with a challenge associated with significant morbidity.

Methods: We present a case of a 20-year-old woman who had a hematoma in the right middle cerebellar peduncle with a ventricular rupture. Angiography revealed an arteriovenous malformation (AVM) located in the same portion, extending from the lateral surface near the entry zone of the trigeminal nerve to the paraventricular area of the fourth ventricle, which was completely resected through a posterior transpetrosal approach.

Gross total removal of gliomas in the pulvinar and correlative microsurgical anatomy.

Tumors in the pulvinar tend to present as circumscribed lesions with exophytic growth into the lateral and third ventricles. These lesions may be best explored via a parietal-transcortical-transventricular approach. If the tumor extends posteriorly or inferiorly, a posterior-interhemispheric-transtentorial approach may provide a good angle of access.