How I do it: paramedian supracerebellar transtentorial approach for a temporomesial glioma

Background Classical approaches to the temporomesial region (TMR) include transtemporal, transylvian, or subtemporal. The supracerebellar infratentorial, initially developed to access dorsolateral cavernomas, has of late shown its versatility to access areas around the central core. The TMR is one such area that can be accessed through this approach with the addition of a tentorial incision. Method The paramedian supracerebellar transtentorial approach (PSCTA) is described along with its advantages and limits compared to other approaches to treat TMR gliomas. Conclusion The PSCTA offers a basal panoramic view of the TMR without the need of retraction, cortical incision, and white matter transgression.