TechniqueTransoral transclival removal of anteriorly placed cavernous malformations of the brainstem
Section snippets
Case 1
This 23-year-old man was admitted to a peripheral neurological institution with numbness, subsequent weakness of the left side on his body, and persistent singultus. Computed tomography (CT) demonstrated the presence of an intrapontine hemorrhage (Figure 1). No abnormalities were detected on the angiogram; the lesion was diagnosed clinically as a deep-seated cavernous malformation. After admission to our neurosurgical department a cranial MRI was obtained. The investigation corroborated the
Case 2
This 39-year-old woman suffered acute onset of vertigo, with nausea and vomiting, disturbance of eye movements, and numbness of the left hand and leg. MRI demonstrated a cavernous malformation in the ventral part of the medulla oblongata (Figure 6).
Discussion
Direct surgery for cavernous malformations of the brain stem is considered one of the most difficult neurosurgical operations because of the unique anatomic features of that area 3, 34. However, in the last few years we have had the opportunity to study the specific anatomy including small details in regions of interest, thanks to the development of preoperative magnetic resonance imaging 12, 32, 38. By taking into consideration the individual patho-anatomic situation we are able to plan an
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The benefit and outcome prediction of acute surgery for hemorrhagic brainstem cavernous malformation with impending respiratory failure
2021, Journal of Clinical NeuroscienceCitation Excerpt :Surgical resection is acknowledged as the optimal treatment for symptomatic BSCMs [1,2,5–10]. There are numerous reports on the surgical timing, approaches, and techniques for treating BSCMs [1,5,7–24]. The majority of clinical symptoms of hemorrhagic BSCM usually can be stabilized for approximately 2–3 weeks to improve surgical planning and treatment [1,8,25].
Endoscopic Transnasal Transclival Approach to a Pontine Cavernoma with Associated Developmental Venous Anomaly
2018, World NeurosurgeryCitation Excerpt :Armed with this knowledge, minimally invasive techniques can be used to directly approach the lesion with minimal intraoperative trauma.5 Previous case series have described transoral and transclival routes to access these lesions.6,7 More recently, endoscopic endonasal techniques have been used for the removal of ventral skull base lesions, with significant improvement in operative morbidity and mortality compared with open approaches.8-10
Endoscopic Approaches to Skull Base Lesions
2018, Principles of Neurological SurgeryCheiro-pedal syndrome: A revisit of etiology, localization and outcome
2017, Clinical Neurology and NeurosurgeryTwo cases of ventral midbrain cavernous malformations successfully removed through orbitozygomatic interpeduncular approach
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