An infratentorial cranial surgical approach is described as which of the following?

• A. Incision made at the nape of the neck
• B. Incision behind the hairline
• C. Incision beneath the upper lip
• D. Incision through the temple

Answer: (A)

The key idea is that an infratentorial approach targets the posterior fossa, the area below the tentorium that contains the cerebellum and brainstem. Surgically, this region is most safely reached from below the skull, so the classic route is a suboccipital incision in the nape of the neck, over the occipital bone. This placement gives direct access to the foramen magnum and posterior fossa with minimal disturbance to supratentorial structures.

Incisions behind the hairline are more associated with scalp or posterior-superior approaches that don’t specifically expose the infratentorial compartment. An incision through the temple is a lateral, more anterior approach aimed at supratentorial structures such as the temporal lobe. An incision beneath the upper lip is a transoral route to anterior skull base or ventral brainstem regions, not the posterior fossa from below.