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Figure 13: Patient 22. Right occipital craniotomy, posterior interhemispheric, transtentorial approach adopted in prone position with the Table tilted about 20°-30° toward the side of approach. (a) The dural exposure that extends until the rim of the torcula and transverse sinus inferiorly and the posterior part of the superior sagittal sinus medially. (b) Gentle lateral retraction of the right parieto-occipital lobe exposes the falx cerebri and its junction with the tentorium that encloses the straight sinus within its leaves at the junctional area. The tentorium is traced until its incisura parallel to the straight sinus. (c) The tentorial surface is coagulated and divided parallel and slightly away from the straight sinus and the arachnoidal covering of the epidermoid removed exposing the tumor. (d) The vein of Galen and basal vein of Rosenthal and (e) the posterior thalamus, collicular plate and the quadrigeminal cistern are visible following tumor removal. (f) The lax brain after the procedure

Figure 13: Patient 22. Right occipital craniotomy, posterior interhemispheric, transtentorial approach adopted in prone position with the Table tilted about 20°-30° toward the side of approach. (a) The dural exposure that extends until the rim of the torcula and transverse sinus inferiorly and the posterior part of the superior sagittal sinus medially. (b) Gentle lateral retraction of the right parieto-occipital lobe exposes the falx cerebri and its junction with the tentorium that encloses the straight sinus within its leaves at the junctional area. The tentorium is traced until its incisura parallel to the straight sinus. (c) The tentorial surface is coagulated and divided parallel and slightly away from the straight sinus and the arachnoidal covering of the epidermoid removed exposing the tumor. (d) The vein of Galen and basal vein of Rosenthal and (e) the posterior thalamus, collicular plate and the quadrigeminal cistern are visible following tumor removal. (f) The lax brain after the procedure