Fully endoscopic access and resection of hemorrhaged cavernous malformation of the posterior midbrain

Giulio Cecchini; Giovanni Vitale; Thomas J Sorenson; Francesco Di Biase

doi:10.3171/2019.7.FocusVid.1950

Fully endoscopic access and resection of hemorrhaged cavernous malformation of the posterior midbrain

Neurosurg Focus Video. 2019 Jul 1;1(1):V14. doi: 10.3171/2019.7.FocusVid.1950. eCollection 2019 Jul.

Authors

Giulio Cecchini¹, Giovanni Vitale¹, Thomas J Sorenson^{2

3}, Francesco Di Biase¹

Affiliations

¹ Department of Neurologic Surgery, San Carlo Hospital, Potenza, Italy.
² Department of Neurologic Surgery, Mayo Clinic, Rochester; and.
³ School of Medicine, University of Minnesota, Minneapolis, Minnesota.

Abstract

Cavernous malformations in the midbrain can be accessed via several safe entry zones. The accepted rule of thumb is to enter at the point where the lesion is visible at the surface of the brainstem to pass through as little normal brain tissue as possible. However, in some cases, in order to avoid critical neural structures, this rule may not apply. A different safe entry zone can be chosen. Our video presents a case of a ruptured cavernous malformation in the midbrain reaching its anterior surface which was successfully resected via a posterolateral route using the supracerebellar infratentorial approach. The video can be found here: https://youtu.be/j7VTqRO7qd4.

Keywords: brainstem; cavernous malformation; endoscopy; infratemporal approach; midbrain; video.