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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(02): 557-560
DOI: 10.4103/ajns.AJNS_246_18
Case Report

Surgical treatment of brainstem cavernous malformation with concomitant developmental venous anomaly

Vania Georgieva
Department of Neurosurgery, Sofiamed Hospital, Sofia University St. Kliment Ohridski, Sofia
,
Emil Krastev
Department of Neurosurgery, Sofiamed Hospital, Sofia University St. Kliment Ohridski, Sofia
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Surgical resection of brainstem cavernous malformations (BCMs) is a high-risk procedure and can be challenging to the neurosurgeon. Lateral surgical routes are becoming increasingly used to approach ventrolaterally brainstem cavernoma. Surgical approach decision depends on the location of the cavernoma in the brainstem and a possible association with brainstem developmental venous anomalies (DVAs). DVA can affect the formation and clinical course of cavernous malformation (CM). CMs related to DVAs tend to have more aggressive behavior than isolated CM. In cases of DVAs associated with hemorrhage, CMs are most often the site of bleeding rather than DVAs themselves. In this case report, we present a 24-year-old woman with a pontomedullary CM and associated dorsally located DVA. BCM was operated through a far lateral suboccipital craniotomy. Brainstem entry point was at inferior olive with extension to the pontomedullary sulcus. This approach should be preferred as a safe surgical exposure to the central and paramedian pontomedullary cavernoma, especially in the cases with associated intraparenchymal brainstem DVA. Such surgical exposure allows preservation of the concomitant brainstem DVA.

Key-words:

Brainstem cavernoma - developmental venous anomalies - far lateral approach - hemorrhage

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Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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