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To define the area of the occipital lobe in which retraction is least harmful, the surface anatomy of the brain, course of the optic radiations, and microsurgical anatomy of the occipital transtentorial approach were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Twelve formalin-fixed cadaveric adult heads were examined with the aid of a surgical microscope and 0\u00b0 and 45\u00b0 endoscopes. The optic radiations were examined by fiber dissection and MR tractography techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The arterial and venous relationships of the lateral, medial, and inferior surfaces of the occipital lobe were defined anatomically. The full course of the optic radiations was displayed via both fiber dissection and MR tractography. Although the stems of the optic radiations as exposed by both techniques are similar, the terminations of the fibers are slightly different. The occipital transtentorial approach provides access for the removal of lesions involving the splenium, pineal gland, collicular plate, cerebellomesencephalic fissure, and anterosuperior part of the cerebellum. An angled endoscope can aid in exposing the superior medullary velum and superior cerebellar peduncles.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Anatomical findings suggest that retracting the inferior surface of the occipital lobe may avoid direct damage and perfusion deficiency around the calcarine cortex and optic radiations near their termination. An accurate understanding of the course of the optic radiations and vascular relationships around the occipital lobe and careful retraction of the inferior surface of the occipital lobe may reduce the incidence of postoperative visual field defect.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.4.jns162805","type":"journal-article","created":{"date-parts":[[2017,10,20]],"date-time":"2017-10-20T13:59:51Z","timestamp":1508507991000},"page":"188-197","source":"Crossref","is-referenced-by-count":22,"title":["Prevention of postoperative visual field defect after the occipital transtentorial approach: anatomical study"],"prefix":"10.3171","volume":"129","author":[{"given":"Satoshi","family":"Matsuo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kyushu Central Hospital;"},{"name":"Department of Neurosurgery, University of Florida, College of Medicine, Gainesville, Florida; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serhat","family":"Baydin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Florida, College of Medicine, Gainesville, Florida; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abuzer","family":"G\u00fcng\u00f6r","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Florida, College of Medicine, Gainesville, Florida; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik H.","family":"Middlebrooks","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noritaka","family":"Komune","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology Head and Neck Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Iihara","sequence":"additional","affiliation":[{"name":"Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert L.","family":"Rhoton","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Florida, College of Medicine, Gainesville, Florida; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neuroimage","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1016\/S1053-8119(03)00336-7","article-title":"How to correct susceptibility distortions in spin-echo echo-planar images: application to diffusion tensor imaging","volume":"20","author":"Andersson JLR","year":"2003","unstructured":"Andersson JLR, Skare S, Ashburner J: How to correct susceptibility distortions in spin-echo echo-planar images: application to diffusion tensor imaging. 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