Background: The mediobasal temporal region has been divided into three portions: anterior, middle, and posterior. Surgical access, especially to the middle portion, presents a formidable challenge to neurosurgeons, and much controversy still exists regarding the selection of the surgical approach to this region.
Case report: We used the small petrosal approach to the middle portion of the mediobasal temporal region in a patient with intractable seizures caused by a cavernous angioma in this region. Using this approach, we selectively removed the lesion without postoperative deficits.
Conclusions: The small petrosal approach was found to be useful and safe as an alternative technique for selective removal of the lesion in the middle portion of the mediobasal temporal region.