Surgical video of transsylvian resection of prechiasmatic craniopharyngioma

Abstract

The Sylvian fissure (SF), also referred to as the lateral sulcus, is one of the most prominent anatomical landmarks on the lateral surface of the cerebral hemisphere. This fissure separates the frontal and parietal lobes superiorly from the temporal lobe inferiorly and forms an important corridor in neurosurgical procedures. Within the depth of the fissure lies the Sylvian cistern, which contains critical neurovascular structures such as the middle cerebral artery (MCA) and its branches, superficial Sylvian veins, and arachnoid trabeculae. We present an operative video of a 16-year-old boy who presented with a bifrontal headache and visual impairment for 1 month. He was subjected to transsylvian resection of the suprasellar lesion, after which there was significant improvement in his symptoms. This manuscript highlights the surgical technique of SF dissection with emphasis on the principles of microneurosurgery.