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CASE REPORT
Year : 2014  |  Volume : 9  |  Issue : 4  |  Page : 243

Anterior petrosal approach for brainstem cavernoma


Department of Neurosurgery and Gamma Knife Radiosurgery, P D Hinduja National Hospital and Medical Research Centre, V S Marg, Mahim, Mumbai, India

Correspondence Address:
K Misra Basant
Department of Neurosurgery and Gamma Knife Radiosurgery, P D Hinduja National Hospital and Medical Research Centre, V S Marg, Mahim, Mumbai - 400 016
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1793-5482.146649

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Brainstem cavernomas (BC) comprise about 5-18% of intracranial vascular malformations. The annual hemorrhage rate varies depending on the study design ranging from as low as 0.25% per patient-year in a retrospective study [2] to 1.6-3.1% per patient-year in prospective studies. [4],[5] The annual event rate is significantly higher in deep (brainstem, diencephalon) and infratentorial cavernomas when compared to their counterparts in other locations. [5] The management of BC can be conservative or surgical depending upon the mode of clinical presentation. Surgical excision of a BC is a challenge because of critical anatomy. We present a case of BC, which was totally excised with anterior petrosal approach. Anterior petrosal approach has been used for excision of BC in only 17 cases until now. [6] The use of preoperative diffusion tensor imaging, tractography, intra-operative navigation, and cranial nerve monitoring will help in reducing the morbidity.


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