2017 Volume 45 Issue 4 Pages 266-269
Brainstem cavernous hemangiomas with recurrent bleeding and gradual neurological deterioration should be considered an indication for surgical treatment. However, surgery is challenging for cavernous hemangiomas located in the ventral part of the pons. In such cases, safe surgical access to the brainstem is limited and obtaining a good surgical field, regardless of the approach selected, is often difficult. We successfully treated a 73-year-old man with a history of three episodes of intracranial bleeding associated with a cavernous hemangioma located in the ventral pons. The hemangioma was removed via the supratrigeminal zone of the brainstem using an anterior transpetrosal approach. We conclude that the anterior transpetrosal approach is particularly useful for accessing lesions located in the upper ventral pons via the supratrigeminal zone because it provides a wide and shallow surgical field above the trigeminal nerve without requiring retraction of the cerebellum.
