LAUSR

The pretemporal (also known as “half-and-half ”) approach provides a wide exposure of the interpeduncular cistern and the distal posterior circulation. In this video, we illustrate the main steps of the pretemporal approach: wide opening of the sylvian fissure and release of deep arachnoid attachments of the temporal lobe. Next, posterior mobilization and retraction of the temporal lobe exposes the third nerve. The third cranial nerve is then separated from its arachnoid connections to the uncus and followed to the interpeduncular fossa. This approach provides full access to the interpeduncular fossa and combines the benefits of the transsylvian route and the subtemporal approach to this region.