Brainstem cavernous malformations: Experience case series

Objective: The purpose of this single centre retrospective study is to provide an institutional review of surgically treated brainstem cavernous malformations. Methods: The clinical experience from January 2013 to September 2014 is evaluated. All medical records and images were reviewed in order to retrieve the most important data regarding epidemiology, clinical picture, radiological findings and surgical outcomes. Results: Eight patients (5 female and 3 male) underwent surgical resection of brain stem cavernoma to alleviate the symptoms caused by brain stem cavernoma. Age ranged from 19 to 53 years (mean 34 years). Headache was common symptom followed by cranial nerve deficit. Seven patients had one or more episodes of haemorrhage documented by magnetic resonance imaging. Pons was the most common location. Surgery was performed under microsurgical conditions with endoscopic assistance, using neuronavigation, and neurophysiological monitoring. After resection during follow-up, 5 patients had improvement in the modified Rankin scale. The preoperative average Rankin score was 1.75 points and had improved at the last follow up (minimum follow up six months) by 0.63 points. Conclusions: Brain stem cavernomas can be resected safely with surgical approach using meticulous microsurgical technique surgical approach. The additional use of modern tools such as neuronavigation, endoscopic assistance, and monitoring can contribute to the safety of the procedure. Goal of surgical intervention to achieve the complete resection of the lesion, without any neurological impairment. Keywords: brain stem; cavernoma; Rankins scale