Infratentorial supracerebellar approach

Last edit by Alaric Steinmetz on

Synonyms: SCIT Approach, Supracerebellar Infratentorial Approach

The infratentorial supracerebellar approach provides a safe route to lesions in the pineal region[^1] and can be used, for example, for the surgical removal of Pineal cysts[^3] [^4].

SCIT approach MRI
Schematic illustration of the supracerebellar infratentorial (SCIT) approach on an MRI image.

Positioning

An infratentorial supracerebellar approach can be performed, for example, with the patient in the sitting position or in Concorde positioning. The advantage of the sitting position is gravitational retraction of the Cerebellum, which, depending on the lesion, can optimally open the surgical access corridor.

Classification

Depending on the angle of approach, the infratentorial supracerebellar approach is classified as median, paramedian, lateral, or far-lateral[^2].

Classification of the approach according to location
Schematic drawing of the various subtypes of the supracerebellar infratentorial approach according to location. Illustration adapted from Matsuo S. et al. JNS. 2017. DOI: 10.3171/2016.7.JNS16277

Side of approach

In midline lesions, the following factors may influence the choice of side of approach[^4]:

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