Lydia Gregg, MA, CMI, FAMI

Ellicott City, Maryland United States

This illustration summarizes the supracerebellar transtentorial approach for selective amygdalohippocampectomy. This posterior approach through a tentorial incision involves elevating the transverse sinus to access temporal lobe structures such as the hippocampus and amygdala.

Purpose
The purpose of the illustration is to provide an overview of the supracerebellar transtentorial approach for selective amygdalohippocampectomy for an audience of neurosurgeons.
Part A depicts a surgeon's view of the initial incisions and craniotomy. A small superior view of the brain clarifies the angles of the parasagittal and coronal sections shown in Part B.
Part B is intended to highlight the depth of access achieved by this approach using selective lighting to draw the viewer's eye to the areas of focus. The surgical field is depicted with bright, warm-hued, high-contrast lighting, while the planes of section and background are treated with dark, cool-hued, low-contrast lighting. The viewing angle and planes of section allow for appreciation of features not visible from the surgeon's view, including the elevated transverse sinus, tentorial incision, and trochlear nerve locations.
This piece is laid out to be included in a larger scientific poster and spans 18 inches wide. The text exceeds a 7:1 contrast ratio in accordance with WCAG accessibility standards.

Equipment
The linework for the piece was sketched and finalized on a Wacom Cintiq 22. The piece was colorized in Photoshop and created using DICOM references in 3DSlicer.