Microsurgical resection of intraventricular tumor through the posterior interhemispheric transparieto-occipital fissure approach: Operative video

Background: Lesions of the atrium of the lateral ventricle remain surgically challenging due to their deep location and proximity to the optic radiations. We demonstrate the posterior interhemispheric transparieto-occipital fissure approach for microsurgical resection of an atrial intraventricular meningioma. Case Description: A 75-year-old patient presented with progressive cognitive decline and seizures. Magnetic resonance imaging demonstrated a left atrial intraventricular mass with peritumoral edema and mass effect. Microsurgical resection was performed through a posterior interhemispheric corridor using a paramedian parieto-occipital craniotomy. The transparieto-occipital fissure was opened to access the ventricular atrium, allowing internal tumor debulking, early devascularization, and gross-total resection without neurological complications. Histopathological examination confirmed meningioma. The Institutional Review Board approval was not required according to institutional policy. Written informed consent for the procedure and publication was obtained from the patient. Conclusion: The posterior interhemispheric transparieto-occipital fissure approach provides a safe and effective surgical corridor to atrial intraventricular tumors while minimizing cortical transgression and preserving critical white matter pathways. This operative video emphasizes the key anatomical landmarks and microsurgical nuances that facilitate maximal safe resection of these challenging lesions.