Candanedo Carlos, Moscovici Samuel, Spektor Sergey
Department of Neurosurgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Neurosurg Focus Video. 2019 Oct 1;1(2):V21. doi: 10.3171/2019.10.FocusVid.19430. eCollection 2019 Oct.
Removal of brainstem cavernous malformation remains a surgical challenge. We present a case of a 63-year-old female who was diagnosed with a large cavernoma located in the medulla oblongata. The patient suffered three episodes of brainstem bleeding resulting in significant neurological deficits (hemiparesis, dysphagia, and dysarthria). It was decided to remove the cavernoma through a left-sided modified far lateral approach. The operative video demonstrates the surgical steps and nuances of a complete removal of this complex medulla oblongata cavernous malformation. Total resection was achieved without complications. Postoperative MRI revealed no signs of residual cavernoma with clinical improvement. The video can be found here: https://youtu.be/BTtMvvLMOFM.
切除脑干海绵状血管畸形仍然是一项外科挑战。我们报告一例63岁女性,被诊断为位于延髓的大型海绵状血管瘤。该患者经历了三次脑干出血,导致严重的神经功能缺损(偏瘫、吞咽困难和构音障碍)。决定通过左侧改良远外侧入路切除海绵状血管瘤。手术视频展示了完整切除这个复杂的延髓海绵状血管畸形的手术步骤和细微之处。实现了全切除且无并发症。术后MRI显示无残留海绵状血管瘤迹象,临床症状改善。视频可在此处找到:https://youtu.be/BTtMvvLMOFM 。