Surgery of Cerebral Cavernous Angiomas With Navigational Support

Accurate localization and removal of deep-seated cavernomas through a less invasive approach is still a challenge. The aim of this study is to compare the efficacy of neuronavigation and ultrasound in guiding surgery for resection of deep-seated cavernomas by transsulcal microsurgical approach.

A total of 38 consecutive patients who suffered from deep-seated cavernomas underwent surgery via a transsulcal microsurgical approach in our hospital between September 2016 and March 2018. Patients were randomly divided into 2 groups (20 cases in neuronavigation group and 18 cases in ultrasound group). The clinical features, character of images, and surgical outcome were analyzed.

There was no significant difference between the 2 groups in diameter (16.6 ± 2.7 mm versus 19.6 ± 2.0 mm, P > 0.05) and depth (19.2 ± 2.4 mm versus 22.0 ± 4.6 mm, P > 0.05) of lesions. The ultrasound group had a similar tumor resection rate (100% versus 80%, P = 0.11) and shorter operation time (119.7 ± 4.5 minutes versus 137.3 ± 4.9 minutes, P < 0.05) than that in the neuronavigation group. There was no significant difference between in the symptomatic improvement rate, complication, postoperative hospital stay, and period of follow-up (P > 0.05). No death and recurrence appeared in both groups.

Ultrasound showed certain advantages than neuronavigation in guiding resection of deep-seated cavernomas by transsulcal microsurgical approach.