Abstract
We report 2 cases of surgically treated symptomatic mesencephalic vascular malformation. The first patient, a 56-year-old man, suffered from diplopia and gait disturbance on February 10, 1996. He was transferred and admitted to our hospital. The neurological examination showed left abducens nerve palsy, nystagmus and cerebellar ataxia. MRI revealed a mass lesion in the upper pons-midbrain. The mass was successfully removed by transcerebellomedullary fissure approach through suboccipital craniotomy. The histological diagnosis was cavernous hemangioma. The second patient, a 61-year-old man, suffered from diplopia, dysarthria and gait disturbance on August 21, 1996. On admission, the neurological examination showed left abducens palsy, nystagmus, cerebellar ataxia and right hemisensory disturbance. MRI revealed a large hematoma in the upper pons-midbrain. The hematoma was removed by transoccipital transtentorial approach. The histological diagnosis was capillary telangiectasia. We discuss the surgical approach to the mesencephalic vascular malformation.
