Different approaches have to be considered for lesions of the diencephalic-mesencephalic junction based on the localization, extension of the lesion, and relationship to the ventricular system.
We present the case of a young lady who presented with a cavernoma of the junction of midbrain and diencephalon after an episode of hemorrhage. The microsurgical anatomy of the trans-callosal trans-choroidal approach for this lesion is described along with its advantages and limitations.
The trans-choroidal approach allows adequate access to lesions of the diencephalic-mesencephalic junction that project into the third ventricle.