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Surgical management of brain-stem cavernomas

Ulrich Pechstein, Josef Zentner, Dirk Van Roost (UGent) and Johannes Schramm
(1997) NEUROSURGICAL REVIEW. 20(2). p.87-93
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Abstract
We present a series of seven patients who were operated on for symptomatic brain-stem cavernomas. The following approaches were used: medial suboccipital (N = 4), lateral suboccipital (N = 1), subtemporal-transtentorial (N = 1), and frontal transcortical-transventricular-subchorioidal-trans velum interpositum (N = 1). Intraoperative motor (N = 4) and somatosensory (N = 1) evoked potential monitoring revealed temporary changes in 3 patients. Immediately postoperatively, the following additional deficits were observed in 6 patients: oculomotor nerve paresis (N = 2), abducens nerve paresis (N = 3), facial nerve paresis (N = 2), deafness (N = 1), and increased ataxia (N = 3). One patient died due to septic complications not related to surgery. After a mean observation time of 2 years, 2 patients had improved, 3 were unchanged, and 1 patient deteriorated as compared to his preoperative status. In conclusion, surgical treatment of brain-stem cavernomas, although carrying a significant risk of temporary neurological deterioration is recommended in symptomatic patients in whom the cavernoma seems to reach the surface of the brain-stem. Intra-operative functional topographic mapping and monitoring have proven useful tools lowering the surgical risks in these patients.
Keywords
microsurgery, brain-stem cavernomas, monitoring, VASCULAR MALFORMATIONS, NATURAL-HISTORY, ANGIOMAS, HEMANGIOMAS, STIMULATION, RESECTION, DIAGNOSIS, SURGERY, REMOVAL

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MLA
Pechstein, Ulrich, et al. “Surgical Management of Brain-Stem Cavernomas.” NEUROSURGICAL REVIEW, vol. 20, no. 2, 1997, pp. 87–93, doi:10.1007/BF01138189.
APA
Pechstein, U., Zentner, J., Van Roost, D., & Schramm, J. (1997). Surgical management of brain-stem cavernomas. NEUROSURGICAL REVIEW, 20(2), 87–93. https://doi.org/10.1007/BF01138189
Chicago author-date
Pechstein, Ulrich, Josef Zentner, Dirk Van Roost, and Johannes Schramm. 1997. “Surgical Management of Brain-Stem Cavernomas.” NEUROSURGICAL REVIEW 20 (2): 87–93. https://doi.org/10.1007/BF01138189.
Chicago author-date (all authors)
Pechstein, Ulrich, Josef Zentner, Dirk Van Roost, and Johannes Schramm. 1997. “Surgical Management of Brain-Stem Cavernomas.” NEUROSURGICAL REVIEW 20 (2): 87–93. doi:10.1007/BF01138189.
Vancouver
1.
Pechstein U, Zentner J, Van Roost D, Schramm J. Surgical management of brain-stem cavernomas. NEUROSURGICAL REVIEW. 1997;20(2):87–93.
IEEE
[1]
U. Pechstein, J. Zentner, D. Van Roost, and J. Schramm, “Surgical management of brain-stem cavernomas,” NEUROSURGICAL REVIEW, vol. 20, no. 2, pp. 87–93, 1997.
@article{3212054,
  abstract     = {{We present a series of seven patients who were operated on for symptomatic brain-stem cavernomas. The following approaches were used: medial suboccipital (N = 4), lateral suboccipital (N = 1), subtemporal-transtentorial (N = 1), and frontal transcortical-transventricular-subchorioidal-trans velum interpositum (N = 1). Intraoperative motor (N = 4) and somatosensory (N = 1) evoked potential monitoring revealed temporary changes in 3 patients. Immediately postoperatively, the following additional deficits were observed in 6 patients: oculomotor nerve paresis (N = 2), abducens nerve paresis (N = 3), facial nerve paresis (N = 2), deafness (N = 1), and increased ataxia (N = 3). One patient died due to septic complications not related to surgery. After a mean observation time of 2 years, 2 patients had improved, 3 were unchanged, and 1 patient deteriorated as compared to his preoperative status. In conclusion, surgical treatment of brain-stem cavernomas, although carrying a significant risk of temporary neurological deterioration is recommended in symptomatic patients in whom the cavernoma seems to reach the surface of the brain-stem. Intra-operative functional topographic mapping and monitoring have proven useful tools lowering the surgical risks in these patients.}},
  author       = {{Pechstein, Ulrich and Zentner, Josef and Van Roost, Dirk and Schramm, Johannes}},
  issn         = {{0344-5607}},
  journal      = {{NEUROSURGICAL REVIEW}},
  keywords     = {{microsurgery,brain-stem cavernomas,monitoring,VASCULAR MALFORMATIONS,NATURAL-HISTORY,ANGIOMAS,HEMANGIOMAS,STIMULATION,RESECTION,DIAGNOSIS,SURGERY,REMOVAL}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{87--93}},
  title        = {{Surgical management of brain-stem cavernomas}},
  url          = {{http://doi.org/10.1007/BF01138189}},
  volume       = {{20}},
  year         = {{1997}},
}
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