Lateral-paramedian infratentorial approach in lateral decubitus for pineal tumours.

All classical operative approaches for pineal tumours have important disadvantages. A lateral-paramedian infratentorial approach in lateral decubitus is proposed. It has the advantage that one can reach the pineal region by way of a shorter distance and over a lower situated part of the upper cerebellar surface. Lifting of the transverse sinus becomes unnecessary. The venous vessels can be saved and there is no risk for air embolism or pneumocephalus.