gms | German Medical Science

Objective: The stereotactic suboccipital transcerebellar approach for lesions in the brainstem or cerebellum is widely regarded as technically demanding requiring substantial modifications of the standard methods thus often making a transfrontal approach preferable. In this comprehensive series we aim to present our experience with the stereotactic suboccipital transcerebellar approach using two standard stereotactic systems.

Method: In the period of 2000 - 2014 74 patients (mean age 44.4 years) with lesions of the brainstem or cerebellum underwent stereotactic surgery either for diagnostic purposes or volume reduction and drainage of cystic lesions or an isolated 4^th ventricle. In 59 patients frame-based surgery was performed using the Riechert-Mundinger stereotactic system preferentially mounted in an inverted fashion, the Leksell stereotactic system was used in 15 patients. For both frames standard stereotactic systems were used. Analysis of intraoperative stereotactic technique, achievement of predefined surgical objectives and perioperative complications was carried out.

Results: In this series the stereotactic suboccipital transcerebellar approach proved to be simply performed using a standard stereotactic system. Using either stereotactic system the predefined surgical objective was achieved in 89.2%. A verified neuropathological diagnosis was obtained in 87.8%. Minor perioperative complications occurred in 9.5%. There was no surgery-related permanent morbidity or mortality.

Conclusions: In this comprehensive series the stereotactic suboccipital transcerebellar approach using a standard stereotactic system was proven to be a favorable stereotactic surgical approach with a high diagnostic success rate and no permanent morbidity in the current series.