Endoscopic Endonasal Resection of a Pontine Brainstem Cavernoma

Surgical treatment of brainstem cavernoma is controversial.¹ With modern surgical technique, safe and complete removal of selected brainstem cavernoma is possible.² The choice of optimal corridor must consider various factors, including eloquent structures of the brainstem, cavernoma shape and location, as well as the presence of an exophytic portion to the lesion.^3,4 The endoscopic endonasal approach, with its refinement through the last decade, could offer an optimal corridor for the removal of ventral brainstem cavernomas. This video exemplifies the key surgical steps, advantages of the technique, and relevant anatomy for the endoscopic endonasal removal of a ventrally exophytic pontine cavernoma.