title: Endoscopic endonasal transclival approach to a pontine cavernous malformation: case report.
abstract: Cavernous malformations of the brainstem are difficult to manage because of their location in eloquent tissue and their high propensity for symptomatic bleeding. Traditional neurosurgical approaches are often associated with significant morbidities. Here we present the case of a 15 year-old male patient with an acute onset of severe cephalalgia associated with neurological signs (right cranial nerve VI, VII and VIII palsies). MRI revealed a ventral pontine cavernous malformation with signs of recent bleeding. The lesion was removed by way of an endoscopic endonasal transclival approach. Post-operative neurological examination showed a dramatic improvement in cranial nerves function. The patient remains stable two years after surgery.
authors.affiliation: Otorhinolaryngology 1st Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), University of Insubria, Varese, Italy.
authors.forename: Iacopo
authors.initials: I
authors.lastname: Dallan
authors.affiliation: Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), University of Insubria, Varese, Italy; Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Battaglia
authors.affiliation: Department of Neurosurgery, Azienda Ospedaliera G. Rummo, Benevento, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: de Notaris
authors.affiliation: Department of Neurosurgery, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Caniglia
authors.affiliation: Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), University of Insubria, Varese, Italy; Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy. Electronic address: tzmario@inwind.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Turri-Zanoni
mesh_terms: D000293:Adolescent; D003389:Cranial Nerve Diseases / Q000209:etiology; D004724:Endoscopy / Q000379:methods*; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009421:Nervous System Malformations / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D009666:Nose; D011149:Pons / Q000002:abnormalities*
keywords: Brainstem hemorrhage; Cavernoma; Endonasal; Endoscopic; Skull Base; Transclival