Cavernous malformation of the ventral midbrain successfully removed via a transsylvian-transpeduncular approach: case report.
A 37-year-old woman presented with a rare cavernous malformation of the ventral midbrain with brainstem hemorrhage manifesting as sudden onset of headache and vomiting. The lesion was removed successfully through a transsylvian approach and a medial peduncular route. Postoperatively, her oculomotor nerve paresis worsened temporarily, but diplopia disappeared 2 months after surgery. We recommend the transsylvian-transpeduncular approach if the lesion is located in the ventral midbrain and faces the ventral surface of the brainstem, because of the effective access with minimal neurological deficits.
Ohmura
Tadahiro
T
Department of Neurosurgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan. tadaohm@fukuoka-u.ac.jp
Hirakawa
Katsuyuki
K
Ohta
Mika
M
Utsunomiya
Hidetsuna
H
Fukushima
Takeo
T
D000328:Adult; D003399:Craniotomy / Q000379:methods*; D005260:Female; D005911:Gliosis / Q000209:etiology; D006261:Headache / Q000209:etiology; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications / Q000601:surgery*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology* / Q000601:surgery; D008636:Mesencephalon / Q000098:blood supply* / Q000601:surgery; D009325:Nausea / Q000209:etiology; D015840:Oculomotor Nerve Diseases / Q000209:etiology; D010291:Paresis / Q000209:etiology; D011149:Pons / Q000098:blood supply* / Q000601:surgery; D020127:Recovery of Function