Abstract
We reviewed five surgical cases of brain stem cavernous angioma. The lesion was located in the pons in three patients and the medulla oblongata in two patients. Four cavernous angiomas were removed via the trans-fourth ventricle approach, while one cavernous angioma associated with a large cyst at the cerebellopontine angle was removed via the lateral suboccipital approach. Intraoperative evoked facial electromyography was useful for preventing facial nerve damage during the trans-fourth ventricle approach. The outcome of surgery was good or fair in all patients. Postoperative facial nerve and paramedian pontine reticular formation dysfunction occurred in one patient. Long-term follow-up (4–8 years) showed no recurrent hemorrhage.
Brain stem incisions should be made where the lesion is closest to the brain stem surface.
