Microsurgical Treatment for Posthemorrhagic Cavernoma of Frontal Lobe Coexisting with Unruptured Ipsilateral Middle Cerebral Artery Aneurysm

Cerebral cavernous malformations, also known as cavernomas, are vascular abnormalities of the brain that are clinically associated with a variety of neurologic symptoms that may include hemorrhagic strokes. They are the most common vascular abnormality, representing 10%–25% of all vascular malformat...

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Bibliographic Details
Published in:World neurosurgery 2021-12, Vol.156, p.27-27
Main Authors: Chang M., José Ernesto, Alejandro, Sebastián Aníbal, Paganelli, Samantha Lorena, Vela Rojas, Evelyn Judith, Viera Neves, Ana Paula, Da Costa, Marcos Devanir, Dória-Netto, Hugo Leonardo, Campos Filho, José Maria, Chaddad-Neto, Feres
Format: Article
Language:English
Subjects:
Aged
Aneurysm
Cavernoma
Cavernous malformation
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - surgery
Female
Frontal Lobe - blood supply
Frontal Lobe - diagnostic imaging
Frontal Lobe - surgery
Hemangioma, Cavernous, Central Nervous System - diagnostic imaging
Hemangioma, Cavernous, Central Nervous System - surgery
Humans
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - surgery
Microsurgery - methods
Surgical management
Treatment Outcome
Unruptured aneurysm
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Summary:Cerebral cavernous malformations, also known as cavernomas, are vascular abnormalities of the brain that are clinically associated with a variety of neurologic symptoms that may include hemorrhagic strokes. They are the most common vascular abnormality, representing 10%–25% of all vascular malformations.1 Lesions associated with cavernomas include developmental venous anomalies, capillary telangiectasias, and other vascular malformations2 but not intracranial aneurysms. The latter association is extremely rare; in fact, there is only 1 case reported in the literature, in which the cavernoma was obscured by the presence of a cerebral hemorrhage and an unruptured aneurysm, which was presumed to be the primary cause of the bleeding, thereby misleading the surgeons to treat only the aneurysm.2 There are different alternatives for the management of different types of lesions.3-5 In this 3-dimensional operative video (Video 1), we present a case of a cavernoma associated with hemorrhage coexisting with an unruptured aneurysm in which we achieved complete resolution of both with microsurgical treatment through a pterional approach.6 The patient consented to publication of images.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2021.08.143