How I do it: Subtemporal transtentorial approach for cavernous malformation of the pons

Background Removal of a pontine cavernous malformation requires sufficient exposure since any restriction on surgical freedom may lead to suboptimal visualization of the lesion, injury to the brainstem, and neurological catastrophe. Methods We describe and demonstrate the subtemporal transtentorial...

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Bibliographic Details
Published in:Acta neurochirurgica 2021-06, Vol.163 (6), p.1751-1756
Main Authors: Jean, Walter C., Davis, Gregory L.
Format: Article
Language:English
Subjects:
Brain stem
Hematoma
Hemorrhage
How I Do it - Vascular Neurosurgery - Arteriovenous malformation
Interventional Radiology
Magnetic resonance imaging
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Neurology
Neuroradiology
Neurosurgery
Pons
Surgery
Surgical Orthopedics
Vascular Neurosurgery – Arteriovenous malformation
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Summary:Background Removal of a pontine cavernous malformation requires sufficient exposure since any restriction on surgical freedom may lead to suboptimal visualization of the lesion, injury to the brainstem, and neurological catastrophe. Methods We describe and demonstrate the subtemporal transtentorial approach to a cavernous malformation of the upper pons, with emphasis on adequate surgical exposure while avoiding the need for extensive bone removal of the skull base. Conclusions The meticulous technique is paramount to the successful removal of any brainstem cavernous malformation. Along with the surgical exposure, delicate handling of the malformation is demonstrated in the accompanying operative video.
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-020-04457-9