Surgical Approaches Of Neoplastic Diseases Of The Brain

1. Inferior frontal lobe and parasellar region: bicoronal incision with unilateral or bilateral subfrontal approach, or pterional approach. 
2. Sellar region: trans-sphenoidal approach open or endoscopic, bicoronal incision with unilateral or bilateral subfrontal approach, or pterional approach. 
3. Frontal lobe: linear, curved, or horseshoe incision with frontal craniotomy. 
4. Anterior temporal lobe: linear incision with temporal craniotomy. 
5. Posterior temporal lobe: linear, reverse question mark, or Isle of Mann incision with temporal craniotomy. 
6.  Parietal lobe: linear or horseshoe incision with parietal craniotomy. 
7.  Occipital lobe: linear or horseshoe incision with occipital craniotomy. 
8.  Trigone of the lateral ventricle: linear or horseshoe incision with appropriate craniotomy for superior parietal, middle temporal gyrus, lateral temporo-occipital, or transoccipital approach. 
9. Anterior third ventricle: linear or horseshoe incision with frontal parasagittal craniotomy and interhemispheric/transcallosal or transcortical approach. The third ventricle can then be approached through the interforniceal or transchoroidal (displace the choroid plexus laterally, divide the tela choroidea, and enter the foramen of Monro between the choroid and fornix) approaches . 
10.  Posterior third ventricle/pineal region: linear or horseshoe incision with a. suboccipital transtentorial approach, b. supracerebellar infratentorial approach, c. interhemispheric transcallosal (splenium) approach, and d. transcortical parietal approach (seldom used). 
11. Midline posterior fossa/fourth ventricle: linear incision with suboccipital craniotomy. 
12.  Lateral posterior fossa/CPA: linear incision with retrosigmoid craniotomy.
13. Upper clivus: linear or horseshoe incision with subtemporal approach and anterior petrosectomy. 
14.  Middle and lower clivus: curvilinear incision with combined retrosigmoid posterior temporal. craniotomy and posterior petrosectomy.