{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:24:54Z","timestamp":1794324294857,"version":"4.9.0"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:p>Surgical treatment of lesions in the posterior thalamus, especially those extending laterally, is technically challenging because of a deep surgical field, narrow operative corridor, and the surrounding critical neurovascular structures. The authors describe an occipital transtentorial\/falcine approach (OTFA) that was successfully used in the treatment of a cavernous malformation (CM) extending laterally from thalamus to midbrain. A 40-year-old man complained of progressive right hemiparesis and numbness. Radiological evaluation revealed a large CM in the left thalamus, surfacing on the pulvinar thalami, and extending 4 cm laterally from the midline. In addition to the usual procedures of a right-sided occipital transtentorial approach, the authors incised the falx cerebri to expand the operative corridor to the left thalamus. They achieved generous exposure of the left thalamus through a \u201ccross-court\u201d oblique trajectory while avoiding excessive retraction on the occipital lobe. The CM was completely removed, and no newly developed or worsening deficits were detected postoperatively. To better understand the OTFA and its application, the authors performed a cadaveric dissection. The OTFA provides increased exposure of the posterior thalamus without cortical incision and facilitates lateral access to this area through the \u201ccross-court\u201d operative corridor. This approach adds to the armamentarium for neurosurgeons treating thalamic lesions.<\/jats:p>","DOI":"10.3171\/2016.7.jns16681","type":"journal-article","created":{"date-parts":[[2016,9,30]],"date-time":"2016-09-30T09:59:52Z","timestamp":1475229592000},"page":"165-170","source":"Crossref","is-referenced-by-count":10,"title":["Occipital transtentorial\/falcine approach, a \u201ccross-court\u201d trajectory to accessing contralateral posterior thalamic lesions: case report"],"prefix":"10.3171","volume":"127","author":[{"given":"Kenichiro","family":"Iwami","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masazumi","family":"Fujii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoshi","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns16681","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1016\/j.wneu.2012.04.012","article-title":"Cavernous malformations of the thalamus: a relatively rare but controversial entity","volume":"79","author":"Abla AA,","year":"2013","unstructured":"Abla AA, Spetzler RF: Cavernous malformations of the thalamus: a relatively rare but controversial entity. World Neurosurg 79:641\u2013644, 20132254888710.1016\/j.wneu.2012.04.012"},{"key":"b2-jns16681","series-title":"AJNR Am J Neuroradiol","first-page":"74","article-title":"Cerebral MR venography: normal anatomy and potential diagnostic pitfalls","volume":"21","author":"Ayanzen RH,","year":"2000","unstructured":"Ayanzen RH, Bird CR, Keller PJ, McCully FJ, Theobald MR, Heiserman JE: Cerebral MR venography: normal anatomy and potential diagnostic pitfalls. AJNR Am J Neuroradiol 21:74\u201378, 200010669228"},{"key":"b3-jns16681","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1007\/BF01400496","article-title":"The transcallosal approach for lesions affecting the lateral and third ventricles. Surgical considerations and results in a series of 42 cases","volume":"111","author":"Bellotti C,","year":"1991","unstructured":"Bellotti C, Pappad\u00e0 G, Sani R, Oliveri G, Stangalino C: The transcallosal approach for lesions affecting the lateral and third ventricles. Surgical considerations and results in a series of 42 cases. Acta Neurochir (Wien) 111:103\u2013107, 199110.1007\/BF01400496"},{"key":"b4-jns16681","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"55","DOI":"10.3171\/jns.1976.44.1.0055","article-title":"Anatomical features of the straight sinus and its tributaries","volume":"44","author":"Browder J,","year":"1976","unstructured":"Browder J, Kaplan HA, Krieger AJ: Anatomical features of the straight sinus and its tributaries. J Neurosurg 44:55\u201361, 197610.3171\/jns.1976.44.1.00551244434"},{"key":"b5-jns16681","series-title":"BNI Q","first-page":"20","article-title":"The two-point method: evaluating brain stem lesions","volume":"12","author":"Brown AP,","year":"1996","unstructured":"Brown AP, Thompson BG, Spetzler RF: The two-point method: evaluating brain stem lesions. BNI Q 12:20\u201324, 1996"},{"key":"b6-jns16681","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"814","DOI":"10.3171\/2010.5.JNS091159","article-title":"Supratentorial cavernous malformations in eloquent and deep locations: surgical approaches and outcomes. Clinical article","volume":"114","author":"Chang EF,","year":"2011","unstructured":"Chang EF, Gabriel RA, Potts MB, Berger MS, Lawton MT: Supratentorial cavernous malformations in eloquent and deep locations: surgical approaches and outcomes. Clinical article. J Neurosurg 114:814\u2013827, 201110.3171\/2010.5.JNS09115920597603"},{"key":"b7-jns16681","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1007\/s002340050434","article-title":"Isolated inferior sagittal sinus thrombosis: a case report","volume":"39","author":"Elsherbiny SM,","year":"1997","unstructured":"Elsherbiny SM, Gr\u00fcnewald RA, Powell T: Isolated inferior sagittal sinus thrombosis: a case report. Neuroradiology 39:411\u2013413, 1997922531910.1007\/s002340050434"},{"key":"b8-jns16681","series-title":"Acta Radiol","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1080\/02841850600990318","article-title":"Corpus callosum hematoma secondary to isolated inferior sagittal sinus thrombosis","volume":"47","author":"Erba\u015f G,","year":"2006","unstructured":"Erba\u015f G, Oner AY, Akpek S, Tokgoz N: Corpus callosum hematoma secondary to isolated inferior sagittal sinus thrombosis. Acta Radiol 47:1085\u20131088, 200610.1080\/0284185060099031817135013"},{"key":"b9-jns16681","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/BF01405501","article-title":"Cavernous malformations of the brain stem. A review of 139 cases","volume":"130","author":"Fritschi JA,","year":"1994","unstructured":"Fritschi JA, Reulen HJ, Spetzler RF, Zabramski JM: Cavernous malformations of the brain stem. A review of 139 cases. Acta Neurochir (Wien) 130:35\u201346, 199410.1007\/BF014055017725941"},{"key":"b10-jns16681","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"E805","DOI":"10.1227\/01.NEU.0000343668.44288.18","article-title":"Brainstem cavernous malformations","volume":"64","author":"Gross BA,","year":"2009","unstructured":"Gross BA, Batjer HH, Awad IA, Bendok BR: Brainstem cavernous malformations. Neurosurgery 64:E805\u2013E818, 200910.1227\/01.NEU.0000343668.44288.18"},{"key":"b11-jns16681","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1227\/01.NEU.0000347009.32480.D8","article-title":"Cavernous malformations of the basal ganglia and thalamus","volume":"65","author":"Gross BA,","year":"2009","unstructured":"Gross BA, Batjer HH, Awad IA, Bendok BR: Cavernous malformations of the basal ganglia and thalamus. Neurosurgery 65:7\u201319, 20091957482110.1227\/01.NEU.0000347009.32480.D8"},{"issue":"6","key":"b12-jns16681","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E24","DOI":"10.3171\/2011.3.FOCUS1165","article-title":"The natural history of intracranial cavernous malformations","volume":"30","author":"Gross BA,","year":"2011","unstructured":"Gross BA, Lin N, Du R, Day AL: The natural history of intracranial cavernous malformations. Neurosurg Focus 30:6E24, 20112163122610.3171\/2011.3.FOCUS1165"},{"key":"b13-jns16681","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1097\/00006123-200211000-00017","article-title":"Comparison of posterior approaches to the posterior incisural space: microsurgical anatomy and proposal of a new method, the occipital bi-transtentorial\/falcine approach","volume":"51","author":"Kawashima M,","year":"2002","unstructured":"Kawashima M, Rhoton AL Jr, Matsushima T: Comparison of posterior approaches to the posterior incisural space: microsurgical anatomy and proposal of a new method, the occipital bi-transtentorial\/falcine approach. Neurosurgery 51:1208\u20131221, 200210.1097\/00006123-200211000-0001712383366"},{"key":"b14-jns16681","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1148\/105.3.583","article-title":"Venous drainage to the inferior sagittal sinus","volume":"105","author":"McCord GM,","year":"1972","unstructured":"McCord GM, Goree JA, Jimenez JP: Venous drainage to the inferior sagittal sinus. Radiology 105:583\u2013589, 1972463509610.1148\/105.3.583"},{"key":"b15-jns16681","series-title":"Neurosurg Clin N Am","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1016\/S1042-3680(03)00055-X","article-title":"Intraventricular meningiomas","volume":"14","author":"McDermott MW:","year":"2003","unstructured":"McDermott MW: Intraventricular meningiomas. Neurosurg Clin N Am 14:559\u2013569, 20031502480110.1016\/S1042-3680(03)00055-X"},{"key":"b16-jns16681","series-title":"J Neurooncol","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s11060-005-5971-5","article-title":"Cavernous hemangioma of the thalamus","volume":"71","author":"Mhoyan A,","year":"2005","unstructured":"Mhoyan A, Fulbright R, Bannykh SI: Cavernous hemangioma of the thalamus. J Neurooncol 71:257, 200510.1007\/s11060-005-5971-515735913"},{"key":"b17-jns16681","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"50","DOI":"10.3171\/jns.1999.90.1.0050","article-title":"Cavernous malformations of the brainstem: experience with 100 patients","volume":"90","author":"Porter RW,","year":"1999","unstructured":"Porter RW, Detwiler PW, Spetzler RF, Lawton MT, Baskin JJ, Derksen PT, : Cavernous malformations of the brainstem: experience with 100 patients. J Neurosurg 90:50\u201358, 199910.3171\/jns.1999.90.1.005010413155"},{"key":"b18-jns16681","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"676","DOI":"10.3171\/2014.11.JNS14381","article-title":"The 6 thalamic regions: surgical approaches to thalamic cavernous malformations, operative results, and clinical outcomes","volume":"123","author":"Rangel-Castilla L,","year":"2015","unstructured":"Rangel-Castilla L, Spetzler RF: The 6 thalamic regions: surgical approaches to thalamic cavernous malformations, operative results, and clinical outcomes. J Neurosurg 123:676\u2013685, 20152602400210.3171\/2014.11.JNS14381"},{"key":"b19-jns16681","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"367","DOI":"10.3174\/ajnr.A1794","article-title":"Persistent falcine sinus: is it really rare?","volume":"31","author":"Ryu CW:","year":"2010","unstructured":"Ryu CW: Persistent falcine sinus: is it really rare?. AJNR Am J Neuroradiol 31:367\u2013369, 201010.3174\/ajnr.A179419779000"},{"key":"b20-jns16681","series-title":"Neurosurgery","first-page":"339","article-title":"Transcallosal approach to the anterior ventricular system","volume":"3","author":"Shucart WA,","year":"1978","unstructured":"Shucart WA, Stein BM: Transcallosal approach to the anterior ventricular system. Neurosurgery 3:339\u2013343, 1978740132"},{"key":"b21-jns16681","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"155","DOI":"10.3171\/JNS-07\/07\/0155","article-title":"Anatomy of the falcine venous plexus","volume":"107","author":"Tubbs RS,","year":"2007","unstructured":"Tubbs RS, Loukas M, Louis RG Jr, Shoja MM, Acakpo-Satchivi L, Blount JP, : Anatomy of the falcine venous plexus. J Neurosurg 107:155\u2013157, 20071763988510.3171\/JNS-07\/07\/0155"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/127\/1\/article-p165.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/127\/1\/article-p165.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/127\/1\/article-p165.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T22:35:39Z","timestamp":1742682939000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/127\/1\/article-p165.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":21,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2016.7.jns16681","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7]]}}}