Subtemporal approach for the resection of a midbrain cavernous malformation: evaluation of safe surgical corridors

Neurosurg Focus Video. 2019 Jul 1;1(1):V1. doi: 10.3171/2019.7.FocusVid.19135. eCollection 2019 Jul.

Abstract

Brainstem cavernous malformation management is complex due to its critical location and deleterious effect when bleeding. Therefore, every case should be thoroughly analyzed preoperatively. We present the case of a female patient with a midbrain cavernous malformation. A comprehensive anatomical and clinical analysis of the surgical corridors is done to decide the safest route. A subtemporal approach was done and the lateral mesencephalic sulcus and vein were important anatomical landmarks to guide the safe entry zone. Nuances of technique and surgical pearls related to the safe entry zones of the midbrain are discussed and illustrated in this operative video. The video can be found here: https://youtu.be/vYA-IgiT2lU.

Keywords: midbrain cavernous malformation; midbrain safe entry zone; subtemporal approach; video.