Cerebellar tumor - Pilocytic Astrocytoma

The cerebellum is key for balanced and smooth motor coordination. I was honored to treat this colleague who presented with worsening of his motor skills while operating. How can we best preserve normal cerebellar tissue? Newton has the answer: use gravity in your favor!
This case illustrates the advantages of using the semi-sitting position to facilitate preservation of cerebellar tissue. By using gravity and avoiding fixed retraction, trauma to the cerebellar hemisphere is avoided while gaining excellent exposure to achieve a complete and curative tumor resection. Preservation of cerebellar tissue was of utmost importance for this patient as he requires excellent manual dexterity to continue performing his job as a surgeon. Three months after surgery he return to his previous surgical duties without any difficulties.