Abstract
Objective To explore the surgical strategy for insular cavernous malformations (CMs).Methods Between Dec.2007 and Aug.2013,4 patients with insular CMs were treated surgically through transsylvian approach by using image guidance system (neuronavigation in two cases,ultrasound in four cases).Results The seizure was the initial symptom in 4 patients with insular CMs.The image guidance system provided high-quality intraoperative imaging and guided the perfect operative approach of insular cortex dissection.All CMs were completely removed via transsylvian-transinsular approach.The mean follow-up period was 36.75 months (ranged from 3 to 72 months).Permanent neurologic morbidity after surgery was observed in 1 patient.One patient with dominant hemisphere lesion had temporary dysphonia,and the language function was recovered after 1 week.4 patients were Engel class Ⅰ.Conclusions Surgical resection of insular CMs through transsylvian approach was safe.Neuronavigation and intraoperative ultrasound were recommended,especially for patients whose lesion was located in the dominant hemisphere. Key words: Cavernous malformation; Insula; Transsylvian approach; Neuronavigation; Intraoperative ultrasound
Published Version
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