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J Neurosurg. 2014 Sep;121(3):723-9. doi: 10.3171/2014.5.JNS132276. Epub 2014 Jun 27.

Lateral inferior cerebellar peduncle approach to dorsolateral medullary cavernous malformation.

Author information

1
Department of Neurosurgery, Providence Brain and Spine Institute, Portland, Oregon; and.

Abstract

OBJECT:

Brainstem cavernous malformations (BSCMs) present a unique therapeutic challenge to neurosurgeons. Resection of BSCMs is typically reserved for lesions that reach pial or ependymal surfaces. The current study investigates the lateral inferior cerebellar peduncle as a corridor to dorsolateral medullary BSCMs.

METHODS:

In this retrospective review, the authors present the cases of 4 patients (3 women and 1 man) who had a symptomatic dorsolateral cavernous malformation with radiographic and clinical evidence of hemorrhage.

RESULTS:

All patients underwent excision of the cavernous malformation via a far-lateral suboccipital craniotomy through the foramen of Luschka and with an incision in the inferior cerebellar peduncle. On intraoperative examination, 2 of the 4 patients had hemosiderin staining on the surface of the peduncle. All lesions were completely excised and all patients had a good or excellent outcome (modified Rankin Scale scores of 0 or 1).

CONCLUSIONS:

This case series illustrates that intrinsic lesions of the dorsolateral medulla can be safely removed laterally through the foramen of Luschka and the inferior cerebellar peduncle.

KEYWORDS:

BSCM = brainstem cavernous malformation; CN = cranial nerve; ICP = inferior cerebellar peduncle; cavernous malformation; dorsolateral medulla; inferior cerebellar peduncle; surgical technique

PMID:
24972129
DOI:
10.3171/2014.5.JNS132276
[Indexed for MEDLINE]

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