Surgical Outcomes of Brainstem Cavernous Malformations

, Do-Yeon Kim1; , Hyuk-Rae Cho1; , Yong-Seok Park1; , Je-Beom Hong2; , Han-Kyu Kim2

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2016;12(2):131-134.
Published online September 30, 2016.

Surgical Outcomes of Brainstem Cavernous Malformations

Do-Yeon Kim1 , Hyuk-Rae Cho1 , Yong-Seok Park1 , Je-Beom Hong2 , Han-Kyu Kim2

¹Department of Neurosurgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan ²Department of Neurosurgery, Bundang Jesaeng General Hospital, Sungnam, Korea

Abstract

Objective
Treatment of brainstem cavernous malformation (BSCM) remains a challenge for cerebrovascular surgeons. The purpose of this study is to provide a retrospective review of surgically treated brainstem cavernous malformations.
Methods
We reviewed patient characteristics, surgical approach, lesion location and clinical outcome in 12 patients who were treated by the senior author (H K KIM) at Kosin University Gospel Hospital and Bundang Jaesang General Hospital between 2013 and 2015.
Results
The study included four male (33%) and eight female (67%) patients, with mean age±SD of 40.6±20.2 years. The most common symptoms on presentation were sensory change (83%) and hemiparesis (58%). The BSCMs were distributed as follows: 1 at midbrain, 10 at pons and 1 at medulla. Complete BSCM resection was achieved in all trea ted patients. None of the patients who received treatment died. No patients experienced surgical complications or new postoperative deficits. Complications on last follow-up presentation were tracheotomy and nasogastric (NG) tube (case 1), diplopia (case 6), and NG tube (case 8). Conclusion: Surgical management of BSCM can result in complete resection and acceptable outcomes. The authors found that the benefits of intervention outweigh the risks in patients with the appropriate indications and application of the cranial base approach offers a direct route with good exposure for brain stem lesions.

Key Words: brainstem, cavernous malformation, surgical management