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Table 6 The indications and complications of different surgical approaches to thalamic tumors

From: Surgical resection of unilateral thalamic tumors in adults: approaches and outcomes

Surgical approach Indications Complications
Anterior transcallosal approach The epicenter was located in the anterior thalamus with/without anterior extension to the fontal horn of the lateral ventricle or callosum; The approach is limited laterally by stretching of the pericallosal artery; some cases suffered from transient mental disorders or memory deficits
The epicenter was located in the medial thalamic region with/without extension into the third ventricle
Transfrontal approach The epicenter was located in the anterior thalamus and extended too much laterally (over 2 centimeters from the lateral broader to the middle line) High risk of postoperative seizures
Transtemporal approach The epicenter of the tumor was located in the lateral thalamic region with/without lateral extension to the basal ganglia, adjacent lobes, or the gyrus, or extending beneath the temporal cortex; Visual field defects due to injury to the optic radiation and language disturbances on the dominant side
Tumors arising from the junction of the thalamus and the cerebral peduncle and extended to the thalamic and peduncle to a similar extent
Transinsular approach The epicenter of the tumor was located in the lateral thalamic region with lateral extension to the basal ganglia High risk in internal capsule injuries
Subtemporal approach Tumors located in the pulvinar with posterior extension toward adjacent structures; High risk in cortical draining veins and temporal lobe injuries when elevating the temporal lobe
Tumors arising from the junction of the thalamus and the cerebral peduncle with most of their mass located in the thalamic region
Transpariento-occipital approach Tumors arising from the junction of the thalamus and the cerebral peduncle occupied the cisterna ambiens and extended inferiorly to the infratentorial area Visual field and memory deficits, due to injury to adjacent optic radiation of the crus fornicis covering the thalamus
Posterior transcallosal approach Pulvinar tumors that are primarily located medially (within 1 centimeter from the lateral broader to the middle line) High risk in optic radiation injuries