title: Anterior petrosal approach for brainstem cavernoma.
abstract: Brainstem cavernomas (BC) comprise about 5-18% of intracranial vascular malformations. The annual hemorrhage rate varies depending on the study design ranging from as low as 0.25% per patient-year in a retrospective study[2] to 1.6-3.1% per patient-year in prospective studies.[45] The annual event rate is significantly higher in deep (brainstem, diencephalon) and infratentorial cavernomas when compared to their counterparts in other locations.[5] The management of BC can be conservative or surgical depending upon the mode of clinical presentation. Surgical excision of a BC is a challenge because of critical anatomy. We present a case of BC, which was totally excised with anterior petrosal approach. Anterior petrosal approach has been used for excision of BC in only 17 cases until now.[6] The use of preoperative diffusion tensor imaging, tractography, intra-operative navigation, and cranial nerve monitoring will help in reducing the morbidity.
authors: Department of Neurosurgery and Gamma Knife Radiosurgery, P D Hinduja National Hospital and Medical Research Centre, V S Marg, Mahim, Mumbai, India.
authors: Pandurang B
authors: PB
authors: Mare
authors: Department of Neurosurgery and Gamma Knife Radiosurgery, P D Hinduja National Hospital and Medical Research Centre, V S Marg, Mahim, Mumbai, India.
authors: Omkar N
authors: ON
authors: Churi
authors: Department of Neurosurgery and Gamma Knife Radiosurgery, P D Hinduja National Hospital and Medical Research Centre, V S Marg, Mahim, Mumbai, India.
authors: Basant K
authors: BK
authors: Misra
keywords: Brainstem cavernoma; neuro navigation; petrosal approach; surgery; tractography