A simple method for stereotactic microsurgical excision of small, deep-seated cavernous angiomas.

Eight patients underwent microsurgical excision of small, deep-seated cavernous angiomas (maximum diameter, 0.9 to 2 cm; distance from cortical surface, 3.5 to 6.5 cm) by the stereotactic implantation of a guide catheter. In all cases, the lesion was quickly localized and completely removed. None of the patients had postoperative neurological deficits. Once the guide catheter has been implanted, the stereotactic headframe can be removed, allowing the unobstructed use of the operating microscope with frames not suitable for open surgery. Target localization is not affected by brain movement, which is inevitable during open surgery. The procedure described here is simple to perform and relatively inexpensive. It requires no specially designed equipment, only a standard stereotactic apparatus, an operating microscope, and the usual microsurgical instruments.