Contralateral anterior interhemispheric-transcallosal-transrostral approach to the subcallosal region: a novel surgical technique (original) (raw)

T he subcallosal area is the inferomedial portion of the frontal lobe located rostral to the corpus callosum. Reaching the subcallosal region has been a challenge for neurosurgeons because of its deep location and close relationship with important vascular structures. Inferior routes, such as the fronto-orbitozygomatic transsylvian approach, or anterior routes, such as the infrafrontal interhemispheric approach, have been most commonly used to approach lesions in the subcallosal area. 2-5,8-10, 12, 14, 15,20 The hazard of anterior and inferior routes to the subcallosal region is possible damage to the branches of the anterior cerebral artery (ACA), particularly the hypothalamic and subcallosal branches. Injury to these arterial branches may result in memory impairment, amnestic-confabulatory syndrome, or hypothalamic problems. Additionally, a transventricular preforniceal approach, which is a route ABBREVIATIONS ACA = anterior cerebral artery; ACoA = anterior communicating artery.