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| Name | Resection of brainstem cavernous malform. via perifacial zone thru retrosigmoid ... |
| Video Uploader | Video From American Association of Neurological Surgeons |
| Upload Date | This Video Uploaded At 14-08-2020 15:18:02 |
| Video Discription | Ken Matsushima, MD,1,2 Michihiro Kohno, MD, PhD,1 and Helmut Bertalanffy, MD, PhD2 1Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan; and 2Center for Vascular Neurosurgery, International Neuroscience Institute Hannover, Hannover, Germany Abstract Hemorrhagic brainstem cavernous malformations carry a high risk of progressive neurological deficits owing to recurrent hemorrhages and hence require complete surgical resection while minimizing damage to the dense concentration of nuclei and fibers inside the brainstem. To access lesions inside the lower pons, the senior author (H.B.) has preferred to approach the lesions via the “perifacial zone” through the pontomedullary sulcus from the inferior surface of the pontine bulge for more than 20 years.1,2 This video demonstrates a case of a cavernous malformation inside the lower pons, which was surgically treated via the pontomedullary junction through the retrosigmoid supracondylar approach in a half-sitting position. The lesion was completely removed in piecemeal fashion through a tiny incision on the sulcus, which did not cause any new neurological deficits. The modified Rankin Scale improved from 4 before the surgery to 1, and the patient had no recurrence during the 2 years of follow-up. The advantage of this access and the dissection techniques for this challenging lesion are introduced, based on our experience with more than 230 surgeries of brainstem cavernoma. **Intro music: "Daybreak" by Graeme Rosner |
| Category | Science & Technology |
| Tags | iMovie | cerebellopontine angle | pontomedullary sulcus | posterior fossa | transcondylar | safe entry zone | Journal of Neurosurgery | AANS | Neurosurgical Focus |
