Brainstem cavernomas: a surgical challenge

Abstract

Objective: The authors show their experience with brainstem cavernomas, comparing their data with the ones of a literature review.Methods: From 1998 to 2009, 13 patients harboring brainstem cavernomas underwent surgical resection. All plain films, medicalrecords and images were reviewed in order to sample the most important data regarding epidemiology, clinical picture, radiologicalfindings and surgical outcomes, as well as main complications.Results: The mean age was 42.4 years (ranging from 19 to 70). Nopredominant gender: male-to-female ratio, 6:7. Pontine cases weremore frequent. Magnetic resonance imaging was used as the imagingmethod to diagnose cavernomas in all cases. The mean follow-upwas 71.3 months (range of 1 to 138 months). Clinical presentationwas a single cranial nerve deficit, VIII paresis, tinnitus and hearingloss (69.2%). All 13 patients underwent resection of the symptomaticbrainstem cavernoma. Complete removal was accomplished in 11patients. Morbidity and mortality were 15.3 and 7.6%, respectively.Conclusions: Cavernomas can be resected safely with optimal surgical approach (feasible entry zone) and microsurgical techniques, and the goal is to remove all lesions with no cranial nerves impairment.

Keywords

• Brain stem/abnormalities
• Brain stem/surgery
• Brain diseases
• Hemangioma
• cavernous