Surgical Approaches for the Brain Stem Cavernous Angioma

Abstract

We reviewed 6 surgical cases with brain stem cavernous angioma. Three cavernous angiomas in the mesencephalon were removed via the occipital transtentorial approach. Two pontine angiomas were removed via the trans-forth ventricle approach. A cavernous angioma in the medulla oblongata was removed through the lateral suboccipital approach.
Intraoperative monitoring of somatosensory evoked potential (SEP) and motor evoked potential (MEP) were useful in predicting postoperative neurological deficits. A brain stem incision should be made where the angioma and hematoma are closest to the brain-stem surface.