Anatomy and Telovelar Approach to the Fourth Ventricular Pathology

The telovelar approach is one of the main surgical approaches for pathology around the fourth ventricle and brainstem. It is an anatomical approach that follows natural corridors, limiting disruption of brain tissue. Detailed understanding of the relevant anatomy to the Telovelar approach is necessary for a successful operation, as well as understanding of the surgical technique and adaptations available to the standard telovelar approach depending on pathology. This chapter describes the surgical anatomy relevant to the telovelar approach and provides a summary of the relevant indications, patient positioning, surgical techniques, and complications.