Perry Avital, Sorenson Thomas J, Graffeo Christopher S, Driscoll Colin L, Link Michael J
Department of Neurologic Surgery, Mayo Clinic, Rochester.
School of Medicine, University of Minnesota, Minneapolis; and.
Neurosurg Focus Video. 2019 Oct 1;1(2):V18. doi: 10.3171/2019.10.FocusVid.19389. eCollection 2019 Oct.
Cavernous malformations (CMs) are low-pressure, focal, vascular lesions that may occur within the brainstem and require treatment, which can be a substantial challenge. Herein, we demonstrate the surgical resection of a hemorrhaged brainstem CM through a posterior petrosectomy approach. After dissection of the overlying vascular and meningeal structures, a safe entry zone into the brainstem is identified based on local anatomy and intraoperative neuronavigation. Small ultrasound probes can also be useful for obtaining real-time intraoperative feedback. The CM is internally debulked and resected in a piecemeal fashion through an opening smaller than the CM itself. As brainstem CMs are challenging lesions, knowledge of several surgical nuances and adoption of careful microsurgical techniques are requisite for success. The video can be found here: https://youtu.be/szB6YpzkuCo.
海绵状血管畸形（CMs）是低压、局灶性血管病变，可发生于脑干内且需要治疗，这可能是一项重大挑战。在此，我们展示了通过岩骨后入路对出血性脑干CM进行手术切除。在解剖覆盖的血管和脑膜结构后，根据局部解剖和术中神经导航确定进入脑干的安全入路区域。小型超声探头也有助于获得术中实时反馈。通过一个小于CM本身的开口，以分块方式对CM进行内部减压和切除。由于脑干CM是具有挑战性的病变，成功需要了解一些手术细节并采用精细的显微外科技术。视频可在此处查看：https://youtu.be/szB6YpzkuCo 。
