Surgical management of brain stem vascular malformations.

Vascular malformations of the brain stem are a histologically heterogenous collection of lesions which most often present with sudden and progressive neurologic deficit related to haemorrhage. Since 1987 the authors have treated eleven cases of brain stem vascular malformation. Seven of the patients were treated with complete surgical extirpation of the haematoma and malformation because of progressive neurologic deficit. Four additional patients made a full neurologic recovery and are being carefully observed for signs suggestive of the need for surgical treatment. Complete surgical excision of brain stem vascular malformations is mandatory for patients with progressive neurologic deficit related to recurrent haemorrhage.