Publication year: 2012
Source:World Neurosurgery
Jeffrey C. Mai, Dinesh Ramanathan, Louis J. Kim, Laligam N. Sekhar
Objective The purpose of this study is to provide an institutional retrospective review of surgically treated brainstem cavernous malformations. Methods Between 2005 and 2010, 22 consecutive patients with brainstem cavernous malformations (15 females and 7 males) with a mean age of 43 underwent surgical treatment. Mean volume of the resected cavernous malformations was 0.65cm3. A minimally invasive resection technique was employed for these cases, in conjunction with skull base approaches. Results The mean follow-up period was 26.6 months (range 4-68 months). Of the 22 patients, 9% did not have clear evidence of hemorrhage at the time of presentation. Of the remainder, 22% had two or more MRI-documented instances of hemorrhage. Following resection and during follow-up, 54% of patients had an improvement in their mRS, while 14% were worse compared to their pre-operative presentation. 32% were unchanged. 9% of patients were found to have residual cavernoma post-surgery. Conclusion Our longitudinal experience has guided us to emphasize minimally invasive approaches during resection of the brainstem cavernous malformations, occasionally at the expense of achieving a complete resection, in order to improve patient outcomes.
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