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. 2019 Oct 1;1(2):V19.
doi: 10.3171/2019.10.FocusVid.19394. eCollection 2019 Oct.

Left suboccipital supracerebellar transtentorial approach for resection of tectal cavernous malformation

Hussam Abou-Al-Shaar  1 , Timothy G White  2 , Ivo Peto  2 , Amir R Dehdashti  2
Affiliations

Left suboccipital supracerebellar transtentorial approach for resection of tectal cavernous malformation

Hussam Abou-Al-Shaar et al. Neurosurg Focus Video. .

Abstract

A 64-year-old man with a midbrain cavernoma and prior bleeding presented with a 1-week history of diplopia, partial left oculomotor nerve palsy, and worsening dysmetria and right-sided weakness. MRI revealed a hemorrhagic left tectal plate and midbrain cavernoma. A left suboccipital supracerebellar transtentorial approach in the sitting position was performed for resection of his lesion utilizing the lateral mesencephalic sulcus safe entry zone. Postoperatively, he developed a partial right oculomotor nerve palsy; imaging depicted complete resection of the cavernoma. He recovered from the right third nerve palsy, weakness, and dysmetria, with significant improvement of his partial left third nerve palsy. The video can be found here: https://youtu.be/ofj8zFWNUGU.

Keywords: brainstem; cavernous malformation; lateral mesencephalic sulcus; safe entry zone; transtentorial approach; video.

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Conflict of interest statement

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this publication.

References

    1. Abou-Al-Shaar H, Labib MA, Spetzler RF. Brainstem cavernous malformations. In: Macdonald RL, editor. Neurosurgical Operative Atlas: Vascular Neurosurgery. Vol. 3. Stuttgart: Thieme Medical Publishers; 2018. pp. 242–247.
    1. Asaad WF, Walcott BP, Nahed BV, Ogilvy CS. Operative management of brainstem cavernous malformations. Neurosurg Focus. 2010;29(3):E10. - PubMed
    1. Cavalcanti DD, Morais BA, Figueiredo EG, Spetzler RF, Preul MC.Surgical approaches for the lateral mesencephalic sulcus. J Neurosurg. [epub ahead of print April 12, 2019. DOI: 10.3171/2019.1.JNS182036] - PubMed
    1. Cavalcanti DD, Preul MC, Kalani MY, Spetzler RF. Microsurgical anatomy of safe entry zones to the brainstem. J Neurosurg. 2016;124:1359–1376. - PubMed
    1. Yagmurlu K, Rhoton AL, Jr, Tanriover N, Bennett JA. Three-dimensional microsurgical anatomy and the safe entry zones of the brainstem. Neurosurgery. 2014;10(Suppl 4):602–620. - PubMed

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