Parietooccipital Transventricular Approach for Thalamic Cavernous Malformation: 2-Dimensional Operative Video

Area of Science:

• Neurosurgery
• Neurology
• Medical Imaging

Background:

• Thalamic cavernous malformations present significant surgical challenges due to the thalamus's eloquent nature and deep location.
• Successful resection often requires advanced techniques like stereotactic navigation and specialized instruments.

Purpose of the Study:

• To demonstrate a minimally invasive surgical approach for a large right dorsal thalamic cavernous malformation.
• To illustrate the utility of stereotactic neuronavigation in achieving complete resection with preserved neurological function.

Main Methods:

• A transparietooccipital lobule approach was utilized for ventricular access.
• Stereotactic neuronavigation guided a transcortical trajectory for lesion resection.
• The approach was optimized to access the malformation along its largest dimension.

Main Results:

• Complete resection of the thalamic cavernous malformation was successfully achieved.
• The patient maintained their preoperative neurological baseline postoperatively.
• The transcortical approach minimized transgression of normal brain parenchyma.

Conclusions:

• The transparietooccipital lobule approach combined with stereotactic neuronavigation is a viable and effective strategy for managing deep thalamic cavernous malformations.
• This technique allows for safe and complete resection, preserving neurological function.