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Surgical management of brain-stem cavernomas

(1997) NEUROSURGICAL REVIEW. 20(2). p.87-93
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Organization
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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Citation

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Chicago
Pechstein, Ulrich, Josef Zentner, Dirk Van Roost, and Johannes Schramm. 1997. “Surgical Management of Brain-stem Cavernomas.” Neurosurgical Review 20 (2): 87–93.
APA
Pechstein, U., Zentner, J., Van Roost, D., & Schramm, J. (1997). Surgical management of brain-stem cavernomas. NEUROSURGICAL REVIEW, 20(2), 87–93.
Vancouver
1.
Pechstein U, Zentner J, Van Roost D, Schramm J. Surgical management of brain-stem cavernomas. NEUROSURGICAL REVIEW. 1997;20(2):87–93.
MLA
Pechstein, Ulrich, Josef Zentner, Dirk Van Roost, et al. “Surgical Management of Brain-stem Cavernomas.” NEUROSURGICAL REVIEW 20.2 (1997): 87–93. Print.
@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://dx.doi.org/10.1007/BF01138189},
  volume       = {20},
  year         = {1997},
}

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