American Association of Neurological Surgeons | Resection of anterolat midbrain cavernous malform. via orbitozygomatic transsylvian pretemporal ... @AANSNeurosurgery | Uploaded August 2020 | Updated October 2024, 1 day ago.
Krishna C. Joshi, MD, Hamid Borghei-Razavi, MD, and Varun R. Kshettry, MD
Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio
Abstract
Brainstem cavernomas are benign, angiographically occult, low-flow lesions and constitute 18%–35% of intracranial cavernomas.4,6 They are known to have an annual rupture risk of 2%–6%,2,5 and once symptomatic, they frequently cause progressive neurological morbidity. A 22-year-old lady presented with progressive profound neurologic deficits from three distinct hemorrhages over 2 months. Surgery was indicated given the aggressive natural history, and the lesion now presented to the surface with displacement of corticospinal tracts noted on diffusion tensor imaging.1,7 We describe a surgical technique via an orbitozygomatic transsylvian pretemporal approach with uncal resection to open the oculomotor-tentorial window and resect the lesion.3
**Intro music: "Daybreak" by Graeme Rosner
Krishna C. Joshi, MD, Hamid Borghei-Razavi, MD, and Varun R. Kshettry, MD
Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio
Abstract
Brainstem cavernomas are benign, angiographically occult, low-flow lesions and constitute 18%–35% of intracranial cavernomas.4,6 They are known to have an annual rupture risk of 2%–6%,2,5 and once symptomatic, they frequently cause progressive neurological morbidity. A 22-year-old lady presented with progressive profound neurologic deficits from three distinct hemorrhages over 2 months. Surgery was indicated given the aggressive natural history, and the lesion now presented to the surface with displacement of corticospinal tracts noted on diffusion tensor imaging.1,7 We describe a surgical technique via an orbitozygomatic transsylvian pretemporal approach with uncal resection to open the oculomotor-tentorial window and resect the lesion.3
**Intro music: "Daybreak" by Graeme Rosner
