Suboccipital telovelar approach for microsurgical resection of a hemorrhagic brainstem cavernous malformation in an infant - how I do it

Acta Neurochir (Wien). 2023 Jul;165(7):1863-1867. doi: 10.1007/s00701-022-05404-6. Epub 2022 Nov 1.

Abstract

Background: The resection of brainstem cavernous malformations pose an extreme neurosurgical challenge, especially in infants as very few cases are reported in the literature. The optimal management still needs to be defined, demanding a tailored approach on an individual basis.

Method: Herein, we report our management and surgical technique for the resection of hemorrhagic pontine cavernous malformation in a 9-month-old infant through a suboccipital telovelar approach.

Conclusion: The resection of hemorrhagic brainstem cavernomas is feasible and safe even in selected infant patients. The timing and the microsurgical technique are of paramount importance for the prevention of postoperative deficits.

Keywords: Brainstem; Cavernous malformation; Infant; Telovelar approach.

MeSH terms

  • Cerebral Hemorrhage / surgery
  • Hemangioma, Cavernous* / surgery
  • Hemangioma, Cavernous, Central Nervous System* / diagnostic imaging
  • Hemangioma, Cavernous, Central Nervous System* / surgery
  • Humans
  • Infant
  • Neurosurgical Procedures / methods
  • Pons / surgery