The Pterional-Transsylvian Approach for Tumor in the Temporal Horn: A Case Report

Abstract

A variety of surgical approaches to temporal horn tumors of the lateral ventricle have been described. Magnetic resonance imaging (MRI) and angiography are the preferred modalities for preoperative evaluation and provide important information for the choice of surgical approach. A 59-year-old man was referred to our hospital due to confusion and gait disturbance. On enhanced MRI, a homogeneous enhanced solitary mass was observed within the temporal horn of the left lateral ventricle with transependymal extension. The lesion was accompanied by increased hypervascular tumor blush on preoperative cerebral angiography. Subtotal removal of the temporal horn tumor was performed because the lesion was identified as lymphoma during surgery. The postoperative course was un-eventful. The patient was referred to the oncology department for conventional chemotherapy. Adjuvant chemotherapy improved the clinical outcome. The pterional-transsylvian approach was beneficial for partial removal of the tumor and tissue diagnosis in this case.

Analysis of the Anatomical Variations in Sylvian Fissure Using MRI

“…Pterional-transylvian approach is also useful in diagnosing and safely resecting tumors in the insula and temporal horn without damaging the optic radiation and uncinate fasciculus which can avoid postoperative optic visual field deficits and aphasia. 1 The Sylvian fissure (SF) is the most commonly used anatomical pathway/corridor used in pterional approach. 2 3 Sound knowledge of SF anatomy before neurosurgery can help reduce procedure-related morbidity.…”