Surgical Management of Brainstem Cavernomas: Cases Description

Abstract

SUMMARY

Background: Cavernomas or cavernous angiomas are a type of complex vascular lesions, their particular location in the brain stem represents a challenge for surgical approach given its anatomical and functional characteristics. Advances in microsurgery and intraoperative neuroimaging techniques have allowed a greater understanding of this pathology as well as better clinical results. The objective of this study is to describe the clinical and imaging aspects and to highlight the main surgical aspects taken into account in our experience for the approach to this complex pathology.

Methods: A retrospective review of our database was carried out, identifying those patients who underwent microsurgical surgery for the resection of brainstem cavernomas between the years 2005-2022, discriminating clinically and surgically relevant characteristics.

Results: A total of 7 patients who underwent microsurgical surgery for the resection of brainstem cavernomas were identified. The mean age of operated patients was 33 years, with a predominance of male gender; The type of approach was determined according to the location of the lesion at the brain stem level, as well as its relationship with ventricular or pial surfaces. Most of the patients presented adequate clinical evolution during follow-up.

Conclusion: Stem cavernomas are challenging cerebral vascular pathologies, their surgical approach requires multidisciplinary groups with experience in their management, adequate patient selection and the availability of technological resources are relevant aspects in the clinical outcome.