American Association of Neurological Surgeons | Endoscope-assisted resection of a brainstem cavernoma @AANSNeurosurgery | Uploaded July 2019 | Updated October 2024, 10 hours ago.
Florian Roser, MD, PhD, Luigi Rigante, MD, and Mohamed Samy Elhammady, MD

Department of Neurosurgery, Neurological Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates

Procedures on cavernous malformations of the brainstem are challenging due to their eloquent location. This accounts especially for recurrent cavernomas as surgical scars, adhesions, and functional shift might have occurred since primary surgery. We report on a 38-year-old female patient with a large recurrent brainstem cavernoma, who underwent previous successful surgery and experienced recurrent bleeding about 2 years later. She harbored a large associated developmental venous anomaly (DVA) traversing the cavernoma through the midline of the brainstem. In order to visualize complete resection and preservation of the DVA at the same time, endoscopic-assisted resection within the brainstem after decompression in the semisitting position was performed.

**Intro music: "Daybreak" by Graeme Rosner