SURGICAL APPROACH TO THALAMIC CAVERNOUS MALFORMATIONS: CASE REPORT

Introduction Thalamus is a high eloquent brain region, because it contains important relay nucleus and is surrounded by vital neural and vascular structures. Cavernous malformations involving deep structures such as the basal ganglia and thalamus account for 5–10% of all cerebral cavernomas and can...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Romanian neurosurgery 2024-11, p.82-83
Hauptverfasser: Matei, Claudiu, Filip, Dan, Dancu, Iulia, Nistor, Sofia, Gherman, Joseph
Format: Artikel
Sprache:eng
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 83
container_issue
container_start_page 82
container_title Romanian neurosurgery
container_volume
creator Matei, Claudiu
Filip, Dan
Dancu, Iulia
Nistor, Sofia
Gherman, Joseph
description Introduction Thalamus is a high eloquent brain region, because it contains important relay nucleus and is surrounded by vital neural and vascular structures. Cavernous malformations involving deep structures such as the basal ganglia and thalamus account for 5–10% of all cerebral cavernomas and can cause devastating neurological deficits. Surgical approach to thalamic cavernomas is associated with risks of new or worsening neurologic deficits. The benefit of surgery must be carefully weighed on an individualized basis. There are several surgical routes that can be used to approach thalamic lesions, mainly transcortical and interhemispheric approaches. A particular approach should be selected based on the location of the cavernoma in the thalamus to minimize lesion of the unaffected brain.   Methods We present the case of a 43-year-old right-handed lady with right bleeding posterolateral thalamic cavernoma, admitted to the neurosurgery department of Sibiu MedLife Polisano Hospital in February 2024. The patient underwent surgery, through a transcortical trans-sulcal para-fascicular, navigation guided approach. Preoperative tractography imaging, tubular cerebral corridor retractor system and intraoperative monitoring of the cortico-spinal tract, through motor evoked potentials (transcortical, cortical and subcortical mapping) and of the spinotahamic tract through somatosensory evoked potentials were used. The postoperative course was uneventful and the patient was discharged on the 7th postoperative day.   Conclusions Thalamus is a complex structure located in a deep brain area and surgery for these region carries high risks, so the surgeon must carefully tailor these patients. The transcortical transsulcal para-fascicular approach is feasible and safe using the cerebral tubular corridor, neuronavigation and neuromonitoring. Advanced surgical technology offers the advantages of minimizing the risks of new neurological deficits.
doi_str_mv 10.33962/roneuro-2024-107
format Article
fullrecord <record><control><sourceid>crossref</sourceid><recordid>TN_cdi_crossref_primary_10_33962_roneuro_2024_107</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>10_33962_roneuro_2024_107</sourcerecordid><originalsourceid>FETCH-crossref_primary_10_33962_roneuro_2024_1073</originalsourceid><addsrcrecordid>eNqdzt0KgjAABeARBUn5AN3tBVb7M_VyDE1BnfjT7ZBQKCpjo4vePoueoHNz4MCBD4ANwVvGwj3dmfHeP82IKKYcEezPgEMZ54iHXjgHDqEUoyDgZAlcay94Csc0JMwBXt1Wh1SKDIqyrJSQCWwUbBKRiTyVUIpjVBWqrWEuslhVuWhSVdRrsBi6q-3dX68AiaNGJuhkRmtNP-iHOd8689IE6y9R_4j6Q5xWn_3zeQOGpUHg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>SURGICAL APPROACH TO THALAMIC CAVERNOUS MALFORMATIONS: CASE REPORT</title><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Matei, Claudiu ; Filip, Dan ; Dancu, Iulia ; Nistor, Sofia ; Gherman, Joseph</creator><creatorcontrib>Matei, Claudiu ; Filip, Dan ; Dancu, Iulia ; Nistor, Sofia ; Gherman, Joseph</creatorcontrib><description>Introduction Thalamus is a high eloquent brain region, because it contains important relay nucleus and is surrounded by vital neural and vascular structures. Cavernous malformations involving deep structures such as the basal ganglia and thalamus account for 5–10% of all cerebral cavernomas and can cause devastating neurological deficits. Surgical approach to thalamic cavernomas is associated with risks of new or worsening neurologic deficits. The benefit of surgery must be carefully weighed on an individualized basis. There are several surgical routes that can be used to approach thalamic lesions, mainly transcortical and interhemispheric approaches. A particular approach should be selected based on the location of the cavernoma in the thalamus to minimize lesion of the unaffected brain.   Methods We present the case of a 43-year-old right-handed lady with right bleeding posterolateral thalamic cavernoma, admitted to the neurosurgery department of Sibiu MedLife Polisano Hospital in February 2024. The patient underwent surgery, through a transcortical trans-sulcal para-fascicular, navigation guided approach. Preoperative tractography imaging, tubular cerebral corridor retractor system and intraoperative monitoring of the cortico-spinal tract, through motor evoked potentials (transcortical, cortical and subcortical mapping) and of the spinotahamic tract through somatosensory evoked potentials were used. The postoperative course was uneventful and the patient was discharged on the 7th postoperative day.   Conclusions Thalamus is a complex structure located in a deep brain area and surgery for these region carries high risks, so the surgeon must carefully tailor these patients. The transcortical transsulcal para-fascicular approach is feasible and safe using the cerebral tubular corridor, neuronavigation and neuromonitoring. Advanced surgical technology offers the advantages of minimizing the risks of new neurological deficits.</description><identifier>ISSN: 1220-8841</identifier><identifier>EISSN: 2344-4959</identifier><identifier>DOI: 10.33962/roneuro-2024-107</identifier><language>eng</language><ispartof>Romanian neurosurgery, 2024-11, p.82-83</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27924,27925</link.rule.ids></links><search><creatorcontrib>Matei, Claudiu</creatorcontrib><creatorcontrib>Filip, Dan</creatorcontrib><creatorcontrib>Dancu, Iulia</creatorcontrib><creatorcontrib>Nistor, Sofia</creatorcontrib><creatorcontrib>Gherman, Joseph</creatorcontrib><title>SURGICAL APPROACH TO THALAMIC CAVERNOUS MALFORMATIONS: CASE REPORT</title><title>Romanian neurosurgery</title><description>Introduction Thalamus is a high eloquent brain region, because it contains important relay nucleus and is surrounded by vital neural and vascular structures. Cavernous malformations involving deep structures such as the basal ganglia and thalamus account for 5–10% of all cerebral cavernomas and can cause devastating neurological deficits. Surgical approach to thalamic cavernomas is associated with risks of new or worsening neurologic deficits. The benefit of surgery must be carefully weighed on an individualized basis. There are several surgical routes that can be used to approach thalamic lesions, mainly transcortical and interhemispheric approaches. A particular approach should be selected based on the location of the cavernoma in the thalamus to minimize lesion of the unaffected brain.   Methods We present the case of a 43-year-old right-handed lady with right bleeding posterolateral thalamic cavernoma, admitted to the neurosurgery department of Sibiu MedLife Polisano Hospital in February 2024. The patient underwent surgery, through a transcortical trans-sulcal para-fascicular, navigation guided approach. Preoperative tractography imaging, tubular cerebral corridor retractor system and intraoperative monitoring of the cortico-spinal tract, through motor evoked potentials (transcortical, cortical and subcortical mapping) and of the spinotahamic tract through somatosensory evoked potentials were used. The postoperative course was uneventful and the patient was discharged on the 7th postoperative day.   Conclusions Thalamus is a complex structure located in a deep brain area and surgery for these region carries high risks, so the surgeon must carefully tailor these patients. The transcortical transsulcal para-fascicular approach is feasible and safe using the cerebral tubular corridor, neuronavigation and neuromonitoring. Advanced surgical technology offers the advantages of minimizing the risks of new neurological deficits.</description><issn>1220-8841</issn><issn>2344-4959</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqdzt0KgjAABeARBUn5AN3tBVb7M_VyDE1BnfjT7ZBQKCpjo4vePoueoHNz4MCBD4ANwVvGwj3dmfHeP82IKKYcEezPgEMZ54iHXjgHDqEUoyDgZAlcay94Csc0JMwBXt1Wh1SKDIqyrJSQCWwUbBKRiTyVUIpjVBWqrWEuslhVuWhSVdRrsBi6q-3dX68AiaNGJuhkRmtNP-iHOd8689IE6y9R_4j6Q5xWn_3zeQOGpUHg</recordid><startdate>20241114</startdate><enddate>20241114</enddate><creator>Matei, Claudiu</creator><creator>Filip, Dan</creator><creator>Dancu, Iulia</creator><creator>Nistor, Sofia</creator><creator>Gherman, Joseph</creator><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20241114</creationdate><title>SURGICAL APPROACH TO THALAMIC CAVERNOUS MALFORMATIONS</title><author>Matei, Claudiu ; Filip, Dan ; Dancu, Iulia ; Nistor, Sofia ; Gherman, Joseph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-crossref_primary_10_33962_roneuro_2024_1073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Matei, Claudiu</creatorcontrib><creatorcontrib>Filip, Dan</creatorcontrib><creatorcontrib>Dancu, Iulia</creatorcontrib><creatorcontrib>Nistor, Sofia</creatorcontrib><creatorcontrib>Gherman, Joseph</creatorcontrib><collection>CrossRef</collection><jtitle>Romanian neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matei, Claudiu</au><au>Filip, Dan</au><au>Dancu, Iulia</au><au>Nistor, Sofia</au><au>Gherman, Joseph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>SURGICAL APPROACH TO THALAMIC CAVERNOUS MALFORMATIONS: CASE REPORT</atitle><jtitle>Romanian neurosurgery</jtitle><date>2024-11-14</date><risdate>2024</risdate><spage>82</spage><epage>83</epage><pages>82-83</pages><issn>1220-8841</issn><eissn>2344-4959</eissn><abstract>Introduction Thalamus is a high eloquent brain region, because it contains important relay nucleus and is surrounded by vital neural and vascular structures. Cavernous malformations involving deep structures such as the basal ganglia and thalamus account for 5–10% of all cerebral cavernomas and can cause devastating neurological deficits. Surgical approach to thalamic cavernomas is associated with risks of new or worsening neurologic deficits. The benefit of surgery must be carefully weighed on an individualized basis. There are several surgical routes that can be used to approach thalamic lesions, mainly transcortical and interhemispheric approaches. A particular approach should be selected based on the location of the cavernoma in the thalamus to minimize lesion of the unaffected brain.   Methods We present the case of a 43-year-old right-handed lady with right bleeding posterolateral thalamic cavernoma, admitted to the neurosurgery department of Sibiu MedLife Polisano Hospital in February 2024. The patient underwent surgery, through a transcortical trans-sulcal para-fascicular, navigation guided approach. Preoperative tractography imaging, tubular cerebral corridor retractor system and intraoperative monitoring of the cortico-spinal tract, through motor evoked potentials (transcortical, cortical and subcortical mapping) and of the spinotahamic tract through somatosensory evoked potentials were used. The postoperative course was uneventful and the patient was discharged on the 7th postoperative day.   Conclusions Thalamus is a complex structure located in a deep brain area and surgery for these region carries high risks, so the surgeon must carefully tailor these patients. The transcortical transsulcal para-fascicular approach is feasible and safe using the cerebral tubular corridor, neuronavigation and neuromonitoring. Advanced surgical technology offers the advantages of minimizing the risks of new neurological deficits.</abstract><doi>10.33962/roneuro-2024-107</doi></addata></record>
fulltext fulltext
identifier ISSN: 1220-8841
ispartof Romanian neurosurgery, 2024-11, p.82-83
issn 1220-8841
2344-4959
language eng
recordid cdi_crossref_primary_10_33962_roneuro_2024_107
source DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals
title SURGICAL APPROACH TO THALAMIC CAVERNOUS MALFORMATIONS: CASE REPORT
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T21%3A42%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-crossref&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=SURGICAL%20APPROACH%20TO%20THALAMIC%20CAVERNOUS%20MALFORMATIONS:%20CASE%20REPORT&rft.jtitle=Romanian%20neurosurgery&rft.au=Matei,%20Claudiu&rft.date=2024-11-14&rft.spage=82&rft.epage=83&rft.pages=82-83&rft.issn=1220-8841&rft.eissn=2344-4959&rft_id=info:doi/10.33962/roneuro-2024-107&rft_dat=%3Ccrossref%3E10_33962_roneuro_2024_107%3C/crossref%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rfr_iscdi=true