Gomez-Paz Santiago, Kicielinski Kimberly P, Thomas Ajith, Ogilvy Christopher S
Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Neurosurg Focus Video. 2019 Jul 1;1(1):V28. doi: 10.3171/2019.7.FocusVid.19180. eCollection 2019 Jul.
The decision to resect a cavernous malformation of the brainstem is based on patient- and lesion-specific factors. The patient's age, comorbidities, neurologic condition, and number and severity of symptomatic hemorrhages are crucial to consider. The proximity to the brainstem surface, amount of hematoma, and true lesion size help dictate the surgical corridor. We present a patient with a medullary cavernous malformation who had three hemorrhages and neurologic worsening. The surgical approach was based on detailed preoperative imaging. We performed a far lateral posterior fossa exposure to resect the lesion. The details of surgical planning and the microsurgery are presented. The video can be found here: https://youtu.be/2y-OJ22Zjw8.
决定切除脑干海绵状血管畸形是基于患者和病变的特定因素。患者的年龄、合并症、神经状况以及有症状出血的次数和严重程度是需要考虑的关键因素。病变与脑干表面的接近程度、血肿量以及实际病变大小有助于确定手术通道。我们报告一例患有延髓海绵状血管畸形且发生三次出血并伴有神经功能恶化的患者。手术方法基于详细的术前影像学检查。我们采用远外侧后颅窝入路切除病变。本文介绍了手术规划和显微手术的细节。视频可在此处查看：https://youtu.be/2y-OJ22Zjw8 。
