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J Neurol Surg Rep 2014; 75(02): e236-e240
DOI: 10.1055/s-0034-1387192
Case Report
Georg Thieme Verlag KG Stuttgart · New York

A 34-Year-Old Woman with Brainstem Cavernous Malformation: The Anterior Transcallosal Transchoroidal Approach and Literature Review

Sayied Abdol Mohieb Hosainey
1   Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
,
Torstein R. Meling
1   Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
› Author Affiliations
Further Information

Publication History

26 April 2014

15 June 2014

Publication Date:
21 August 2014 (online)

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Abstract

Mesencephalic cavernous malformations (MeCMs) account for 4 to 35% of the cavernous malformations of the central nervous system and are generally rare. Surgical resection of brainstem cavernomas are high-risk procedures and can be challenging to the neurosurgeon. Several approaches have been described, but the approach must allow for a straight line of sight in which the surgeon, the pial incision, and the MeCM are all collinear. This alignment provides the best view of the lesion while minimizing the need for brainstem retraction. The pial incision should be chosen to minimize the distance to the lesion while avoiding critical nuclei and tracts. In this case report, we present a 34-year-old woman with a MeCM resected by an anterior transcallosal transchoroidal approach with minimal damage to surrounding brain tissue. Although rarely used, it should be considered a valuable alternative to ventrally located brainstem cavernomas.

Keywords

cavernous malformation - brainstem cavernoma - surgical approach - transcallosal transchoroidal approach - surgical complications - brainstem hemorrhage
 

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