Occipital interhemispheric transtentorial approach for the quadrangular lobule of the cerebellum

BACKGROUND: The occipital interhemispheric transtentorial approach (OITT) is widely used for accessing lesions in the pineal region. Although reports are scarce, this approach can also be successfully applied to superior cerebellar lesions, involving the quadrangular lobule. METHODS: We describe the OITT approach for cerebellar quadrangular lobe lesions, providing relevant anatomy, surgical technique, and key technical considerations. CONCLUSION: Gross total resection can be achieved while preserving normal brain tissue and functionOITT is a safe and low-morbidity route for lesions within the cerebellar quadrangular lobe, as it uses a natural anatomical corridor, avoids manipulation of eloquent areas, and minimizes injury to normal brain tissue.