title: Brainstem cavernomas: a surgical challenge.
abstract: OBJECTIVE
  The authors show their experience with brainstem cavernomas, comparing their data with the ones of a literature review.
  
  
  METHODS
  From 1998 to 2009, 13 patients harboring brainstem cavernomas underwent surgical resection. All plain films, medical records and images were reviewed in order to sample the most important data regarding epidemiology, clinical picture, radiological findings and surgical outcomes, as well as main complications.
  
  
  RESULTS
  The mean age was 42.4 years (ranging from 19 to 70). No predominant gender: male-to-female ratio, 6:7. Pontine cases were more frequent. Magnetic resonance imaging was used as the imaging method to diagnose cavernomas in all cases. The mean follow-up was 71.3 months (range of 1 to 138 months). Clinical presentation was a single cranial nerve deficit, VIII paresis, tinnitus and hearing loss (69.2%). All 13 patients underwent resection of the symptomatic brainstem cavernoma. Complete removal was accomplished in 11 patients. Morbidity and mortality were 15.3 and 7.6%, respectively.
  
  
  CONCLUSIONS
  Cavernomas can be resected safely with optimal surgical approach (feasible entry zone) and microsurgical techniques, and the goal is to remove all lesions with no cranial nerves impairment.
authors.affiliation: Hospital Israelita Albert Einstein - HIAE, São Paulo (SP), Brazil. phpaneurocir@gmail.com
authors.forename: Paulo Henrique Pires
authors.initials: PH
authors.lastname: de Aguiar
authors.forename: Carlos Alexandre Martins
authors.initials: CA
authors.lastname: Zicarelli
authors.forename: Gustavo
authors.initials: G
authors.lastname: Isolan
authors.forename: Apio
authors.initials: A
authors.lastname: Antunes
authors.forename: Rogério
authors.initials: R
authors.lastname: Aires
authors.forename: Sérgio Murilo
authors.initials: SM
authors.lastname: Georgeto
authors.forename: Adriana
authors.initials: A
authors.lastname: Tahara
authors.forename: Fahd
authors.initials: F
authors.lastname: Haddad
mesh_terms: D000328:Adult; D000368:Aged; D020295:Brain Stem Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000209:etiology; D003389:Cranial Nerve Diseases / Q000209:etiology / Q000517:prevention & control; D003399:Craniotomy; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011149:Pons / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D014012:Tinnitus / Q000209:etiology; D055815:Young Adult