Thalamomesencephalic cavernoma: anterior transcallosal transchoroidal approach

Francesco Certo,Giuseppe M V Barbagallo,Roberto Altieri,Giada Toccaceli

doi:10.3171/2019.7.focusvid.191213

Abstract

We present a case of a 62-year-old man with acute onset of diplopia, headache, and vomiting for a bleeding thalamomesencephalic cavernoma. The lesion was removed via the anterior transcallosal transchoroidal approach. His head was slightly flexed and a right paramedian craniotomy for an interhemispheric approach was performed. The interhemispheric fissure was split and, after callosotomy, the choroidal fissure was opened along the tenia fornicis to enter the velum interpositum and enlarge the foramen of Monro. The cavernoma was then identified and resected. There were no long-term postoperative neurological deficits. This approach is a valid alternative for thalamomesencephalic lesions.The video can be found here: https://youtu.be/DJdorbzDnH0.

Highlights

We present a case of a 62-year-old man with acute onset of diplopia, headache, and vomiting for a bleeding thalamomesencephalic cavernoma
We present a case of thalamomesencephalic cavernoma removed by anterior transcallosal transchoroidal approach
Superior approaches

Summary

Introduction

We present a case of a 62-year-old man with acute onset of diplopia, headache, and vomiting for a bleeding thalamomesencephalic cavernoma. We present a case of thalamomesencephalic cavernoma removed by anterior transcallosal transchoroidal approach. The patient is a 62-year-old man who presented, after mild brain injury, acute onset of diplopia, headache, and vomiting. Because of persistence of symptoms, he performed a brain CT that showed a right thalamomesencephalic bleeding, with a maximum diameter of 12 mm.

Results

Conclusion