Surgical treatment of brainstem cavernous malformations

Garrett, Mark P.; Spetzler, Robert F.

doi:10.1016/j.surneu.2009.05.031

Cited by 76 publications

(54 citation statements)

References 30 publications

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“…2 In the years since, many authors have been able to confirm the safety of this lateral route. 15,17,25,29,30 In our series as well, no morbidity was observed in the 4 patients who underwent biopsy.…”

Section: Discussionsupporting

confidence: 62%

“…29 Garret and Spetzler, in addressing the question of deep-seated lesions, have suggested that the surgeon must not only consider the shortest path from the surface to the lesion, but also the safest path. 15 This particular consideration of path and safety has been the driving force underlying this study, and we have been extremely satisfied to discover that only 7% of patients described in this series have reported permanent surgical sequelae.…”

Section: Discussionmentioning

confidence: 88%

“…These results compare well with the results of previous series (Table 2). 3,5,8,[15][16][17]21,24,26,31,33,36,38,41 Differences in tumor location, dimension, histology, surgical technique, and grades of resection, along with the absence of a specific subgroup analysis in terms of different surgical approaches, make any comparison difficult. In addition, in our series the small sample size of each group of patients, where different grades of resection could be achieved, prevents further analysis and making definitive conclusions.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%

“…4,20,34 More recently, the need to further reduce the impact of surgical sequelae affecting a patient's quality of life and the refinement of neurophysiological monitoring has pushed some groups to explore and develop lateral alternative approaches to the deep pons. 10,15,17,25 Given these historical considerations, this study focused attention on the technical aspects and results of surgery for deep pontine lesions when approached through the lateral infratrigeminal window.…”

mentioning

confidence: 99%

See 4 more Smart Citations

The lateral infratrigeminal transpontine window to deep pontine lesions

Ferroli

Schiariti

Cordella

et al. 2015

JNS

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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.

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