The paramedian supracerebellar transtentorial approach to the posterior fusiform gyrus

Anthony M.T. Chau, Filippo Gagliardi, Adam Smith, Nicholas R. Pelzer, Fiona Stewart, Pietro Mortini, Samer K. Elbabaa, Anthony J. Caputy, Cristian Gragnaniello

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: The posterior fusiform gyrus lies in a surgically challenging region. Several approaches have been described to access this anatomical area. The paramedian supracerebellar transtentorial (SCTT) approach benefits from minimal disruption of normal neurovascular tissue. The aim of this study was to demonstrate its application to access the posterior fusiform gyrus. Methods: Three brains and six cadaveric heads were examined. A stepwise dissection of the SCTT approach to the posterior fusiform gyrus was performed. Local cortical anatomy was studied. The operability score was applied for comparative analysis on surgical anatomy. Results: The major posterior landmark used to identify the fusiform gyrus with respect to the medial occipitotemporal gyrus was the collateral sulcus, which commonly bifurcated at its caudal extent. Compared with other surgical approaches addressed to access the region, SCTT demonstrated the best operability in terms of maneuverability arc. Favorable tentorial anatomy is the only limiting factor. Conclusions: The supracerebellar transtentorial approach is able to provide access to the posterior fusiform gyrus via a minimally disruptive, anatomic, microsurgical corridor.

Original languageEnglish (US)
Pages (from-to)2149-2154
Number of pages6
JournalActa Neurochirurgica
Issue number11
StatePublished - Nov 1 2016
Externally publishedYes


  • Anatomy
  • Fusiform gyrus
  • Neurosurgical procedures
  • Operability
  • Supracerebellar transtentorial approach

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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