Abstract
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.The video can be found here: https://youtu.be/K1p-Sx7jUpA.
Highlights
Procedures on cavernous malformations of the brainstem are challenging due to their eloquent location
There is a large bleeding cavity again noted in the brainstem as well as an associated developmental venous anomaly (DVA) traversing the midline of the brainstem
0:51 Surgery was planned in the semisitting position under intraoperative nerve monitoring for SSEPs, MEPs, BAEP, as well as EMG and MEP sixth nerve, seventh nerve, and lower cranial nerves
Summary
Procedures on cavernous malformations of the brainstem are challenging due to their eloquent location. This is a 43-year-old female patient who underwent microsurgical resection of a brainstem cavernoma about 18 months earlier with no residual deficit. She appears again with new swallowing deficit, sixth and seventh nerve palsy on the right side, as well as heminumbness and acute hemiparesis of the left side.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
