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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

Surgical approaches to brainstem cavernous malformations.

Adib A Abla¹, Jay D Turner, Alim P Mitha

¹Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.

Neurosurgical Focus

|September 3, 2010

Summary

This summary is machine-generated.

Brainstem cavernous malformations (CMs) are vascular lesions that frequently hemorrhage. Surgical intervention for symptomatic brainstem CMs offers favorable outcomes, outweighing the risks of rehemorrhage.

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Area of Science:

Neurosurgery
Vascular Neurology

Background:

Brainstem cavernous malformations (CMs) are low-flow vascular lesions located in critical brain areas.
These lesions present with symptomatic hemorrhages, occurring more frequently than supratentorial cavernomas.

Purpose of the Study:

To evaluate the efficacy and outcomes of surgical interventions for brainstem cavernous malformations.
To determine the indications for surgery and assess the risks versus benefits of treating these lesions.

Main Methods:

Review of patients with brainstem cavernous malformations treated at a tertiary institution.
Analysis of surgical approaches including retrosigmoid, suboccipital, supracerebellar infratentorial, orbitozygomatic, and far lateral.
Assessment of symptomatic presentation, hemorrhage rates, and postoperative outcomes.

Main Results:

Patients referred to tertiary centers often have aggressive, frequently bleeding lesions.
Indications for surgery include symptomatic lesions, mass effect, or proximity to the pial surface.
While new postoperative deficits can occur, most are transient, and favorable outcomes are common.

Conclusions:

Surgical treatment of brainstem CMs is indicated for symptomatic or high-risk lesions.
Intervention protects patients from devastating rehemorrhage, with benefits outweighing risks in appropriately selected patients.