Türk Nöroşirürji Dergisi 2019 , Vol 29 , Num 1
Approach to Brainstem Lesions
Baran BOZKURT1,İlhan ELMACI2
1Afşin Devlet Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, Kahramanmaraş, Türkiye
2Maslak Acıbadem Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, İstanbul, Türkiye
The surgery of brain stem lesions has been challenging for neurosurgeons due to the presence of critical neural structures in this region. Improvements in electrophysiological monitoring and imaging techniques, together with more precise microsurgical techniques, have enabled better identification of the recommended safe entry zones for brain stem lesions such as cavernous malformations and gliomas. In the anatomical studies performed in recent years and supported by diffusion tensor imaging (DTI), safe entry zones of the mesencephalon, pons and medulla and their relationships with complex internal structures and fiber pathways of the brainstem have been revealed. In the light of recent studies in the literature, we discussed the combination of safe entry zones and the two-point method for making decisions regarding the most appropriate surgical approach for the removal of brainstem lesions. Anahtar Kelimeler : Brainstem, Surgical approach, Neuroanatomy