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Contralateral Transcingulate Approach for Periventricular Cavernous Malformations Presenting With Intraventricular
Amanrai S Kahlon1, Najib Muhammad, Christopher Sollenberger
1Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Operative Neurosurgery (Hagerstown, Md.)
|March 18, 2026
Summary
The contralateral transcingulate approach effectively resects deep brain lesions like cavernous malformations. This surgical technique provides excellent visualization and safe access to challenging medial frontal and parietal lobe tumors.
Area of Science:
- Neurosurgery
- Neuroanatomy
- Cerebral Surgery
Background:
- The contralateral transcingulate-transcallosal approach provides access to deep medial frontal and parietal lobe lesions.
- It allows direct visualization of key anatomic landmarks.
Purpose of the Study:
- To describe the operative anatomy and technique for resecting pericallosal or periventricular cavernous malformations.
- To highlight the use of the contralateral transcingulate approach for lesions presenting with intraventricular or subarachnoid hemorrhage.
Main Methods:
- Three cases of cavernous malformations with hemorrhage were treated using the contralateral transcingulate approach.
- Emphasis was placed on patient positioning, surgical corridors, and vascular manipulation.
Main Results:
- Complete resection was achieved in all three cases without complications.
- Surgical corridors were adjusted based on anatomic variations to ensure safe exposure and minimize retraction.
Conclusions:
- The contralateral transcingulate approach offers a steeper exposure angle for ventricular wall or protruding lesions.
- This technique may provide advantages over traditional approaches for select cases with careful pre-operative planning.
