Methods: A giant tentorial notch meningioma, extending from pineal region to uncal gyrus, medial temporal lobe and left cerebellopontine cisterna, is surgically operated by ligating and sectioning of the unilateral nondominant transverse sinus and splitting the tentorium with the technique of combined supra/infratentorial transsinus approach.

Results: By the combined supra/infratentorial transsinus approach, wide exposure and working space was provided. The total removal of all tumor extensions was achieved with minimal brain retraction. No postoperative complication was noted.

Conclusion: For large extensive tentorial notch lesions, this approach provides wide exposure and working space with minimal occipital and cerebellar lobe retraction, this avoids the related complications. Anahtar Kelimeler : Supra/infratentorial-transsinus approach; transverse sinus; tentorium; pineal-tentorial notch meningioma