S urgery of intraaxial brainstem lesions has been shown to be feasible and is now being performed in selected patients despite the risk of functional brainstem damage. 4,15,20,31 There are many variables that affect the results of this surgery such as patient selection, surgical techniques, and available technologies. In addition, there is currently no consensus surrounding the decision-making process that guides the surgeon to choose this approach. This is particularly true when this surgery is under consideration for deep pontine lesions that require a brainstem incision to be exposed. In fact, the pons remains one of the most protected and inaccessible areas of the brain because its exposition is obstructed by the cerebellum posteriorly, by the petrous bone laterally, and by septic nasal cavities abbreviatioNs CMAP = compound muscle action potential; CN = cranial nerve; DTI = diffusion tensor imaging; GTR = gross-total resection; MEP = motor evoked potential; mRS = modified Rankin Scale; SSEP = somatosensory evoked potential; STR = subtotal resection.