When considering an approach to remove a symptomatic brainstem cavernous malformation, exposure and adequate visualization of the lesion with minimal morbidity should be the primary goals.
We describe the use of the far-lateral transcondylar technique to access a cavernous malformation in the lower anterior pons.
This approach accesses the inferior belly of the pons in an inferior-to-superior direction, where the cavernous malformation approaches the surface between the root exit zones of the abducens (VI) cranial nerves.
We recommend adding this technique to the repertoire of approaches used to resect these technically challenging lesions in selected cases.
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Bertalanffy H, Seeger W (1991) The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction. Neurosurgery 29:815–821
Chen L, Zhao Y, Zhou L, Zhu W, Pan Z, Mao Y (2010) Surgical strategies in treating brainstem cavernous malformations. Neurosurgery 68:609–621
D’Ambrosio AL, Kreiter KT, Bush CA, Sciacca RR, Mayer SA, Solomon RA, Connolly ES Jr (2004) Far lateral suboccipital approach for the treatment of proximal posteroinferior cerebellar artery aneurysms: surgical results and long-term outcome. Neurosurgery 55:39–50, discussion 50–54
Gross BA, Batjer HH, Awad IA, Bendok BR (2009) Brainstem cavernous malformations. Neurosurgery 64:E805–E818, discussion E818
Hauck EF, Barnett SL, White JA, Samson D (2010) The presigmoid approach to anterolateral pontine cavernomas. Clinical article J Neurosurg 113:701–708
Lang DA, Neil-Dwyer G, Iannotti F (1993) The suboccipital transcondylar approach to the clivus and cranio-cervical junction for ventrally placed pathology at and above the foramen magnum. Acta Neurochir (Wien) 125:132–137
Sandalcioglu IE, Wiedemayer H, Secer S, Asgari S, Stolke D (2002) Surgical removal of brain stem cavernous malformations: surgical indications, technical considerations, and results. J Neurol Neurosurg Psychiatry 72:351–355
We thank Kristin Kraus, M.Sc., for editorial assistance in preparing this paper.
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Garber, S.T., Couldwell, W.T. Resection of an inferior pontine cavernous malformation using a far-lateral transcondylar approach. Acta Neurochir 153, 2461–2464 (2011). https://doi.org/10.1007/s00701-011-1201-4
- Cavernous malformation
- Far-lateral approach