Giant brainstem cavernoma in pediatrics: diagnosis and treatment-case report

Childs Nerv Syst. 2024 Mar 7. doi: 10.1007/s00381-024-06347-2. Online ahead of print.

Abstract

Introduction: Brain cavernomas or cavernous angiomas are a rare vascular malformation in the general population, even more so in pediatric patients. Their incidence in this group is less than 5% of all vascular malformations. They are typically found in the cerebral hemispheres in cortico-subcortical locations and, more rarely, in the brainstem.

Objective: To describe the diagnosis, treatment, and follow-up of a case involving a pediatric patient with a giant cavernoma in the brainstem at J.P. Garrahan Hospital.

Materials and methods: The clinical history of the case was retrieved from the database of J.P. Garrahan Pediatric Hospital. Additionally, a literature search was conducted in high-impact factor journals using the PubMed database.

Conclusion: Both the authors of this study and experts consulted through the literature agree that, given the eloquence of the affected area and its challenging accessibility, close monitoring and an expectant approach are advisable for such patients. Nevertheless, when the onset of the case warrants it, surgical intervention is deemed necessary in emergency situations and following the acute phase for complete resolution of the pathology.

Keywords: Approach; Brainstem; Cavernoma; Eloquent area; Floor of the fourth ventricle.