Sayyahmelli Sima, Başkaya Mustafa K
Department of Neurological Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin.
Neurosurg Focus Video. 2019 Jul 1;1(1):V25. doi: 10.3171/2019.7.FocusVid.1998. eCollection 2019 Jul.
In this surgical video, we present a 57-year-old man with neck pain, dizziness, and imbalance. MRI showed a heterogeneously enhancing mass lesion within the posterior medulla at the level of the foramen magnum. Because the patient was symptomatic from this cavernous malformation, the decision was made to proceed with surgical resection. The patient underwent a midline suboccipital craniotomy with C1 laminectomy for surgical resection of the cavernous malformation in the medulla oblongata, with concurrent monitoring of motor and somatosensory evoked potentials. The surgery and postoperative course were uneventful. The postoperative MRI showed gross-total resection of the mass with histopathology indicating a cavernous malformation. The patient continues to do well without recurrence at 7 years of follow-up. In this video, we demonstrate important microsurgical steps for the resection of this challenging and rare vascular malformation. The video can be found here: https://youtu.be/gbGleLowzxo.
在本手术视频中，我们展示了一名57岁男性，他有颈部疼痛、头晕和平衡失调症状。磁共振成像（MRI）显示在枕骨大孔水平的延髓后部有一个不均匀强化的肿块病变。由于该海绵状血管畸形使患者出现了症状，因此决定进行手术切除。患者接受了枕下正中开颅术并切除了C1椎板，以手术切除延髓内的海绵状血管畸形，同时监测运动和体感诱发电位。手术及术后过程顺利。术后MRI显示肿块全切，组织病理学检查表明为海绵状血管畸形。患者在随访7年时情况良好，无复发。在本视频中，我们展示了切除这种具有挑战性的罕见血管畸形的重要显微手术步骤。视频可在此处找到：https://youtu.be/gbGleLowzxo 。
