Giant cavernous malformation in the ventrolateral midbrain with extension into the thalamus: a case report of a paramedian supracerebellar transtentorial approach

• Published in: Acta neurochirurgica Vol. 158; no. 8; pp. 1533 - 1538
• Main Authors: Duan, Hongzhou, Hara, Yosuke, Goto, Tetsuya, Chiba, Akihiro, Hongo, Kazuhiro
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.08.2016; Springer Nature B.V
• Subjects: Adolescent; Case Report - Neurosurgical Techniques; Humans; Interventional Radiology; Male; Medicine; Medicine & Public Health; Mesencephalon - abnormalities; Mesencephalon - surgery; Minimally Invasive Surgery; Neurology; Neuroradiology; Neurosurgery; Neurosurgical Procedures - methods; Surgical Orthopedics; Thalamus - abnormalities; Thalamus - surgery; Cavernous malformation; Surgical approach; Thalamus; Midbrain
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-016-2870-9

Cavernous malformations (CMs) of the midbrain and thalamus are relatively rare and particularly difficult to be resected given their location in eloquent tissues. Here, we report a case of a 14-year-old boy who experienced repeated and progressive right hemiparesis. Image examinations showed a gradually enlarged CM originated in the left ventrolateral midbrain extending to the left thalamus with repeated hemorrhage. By performing a paramedian supracerebellar transtentorial approach, the CM was totally removed, and the patient recovered without any new neurological deficit. The authors’ experience suggests that this approach is eminent in treating giant lesions involving the ventrolateral midbrain and thalamus.