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Endoscope-assisted resection of brainstem cavernous malformations.

Joachim Oertel1, Gerrit Fischer2, Stefan Linsler2

  • 1Department of Neurosurgery, Saarland University Medical Centre, Kirrbergerstraße, Gebäude 90.5, 66421, Homburg, Saarland, Germany. oertelj@freenet.de.

Neurosurgical Review
|May 2, 2022
PubMed
Summary

Neuroendoscopy enhances surgical resection of brainstem cavernous malformations (BSCM), enabling precise, minimally invasive procedures with high gross-total resection rates and improved patient outcomes.

Keywords:
BrainstemCavernomaCavernous malformationEndoscopic neurosurgeryNeuroendoscopy

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Area of Science:

  • Neurosurgery
  • Minimally Invasive Surgery
  • Neuroendoscopy

Background:

  • Brainstem cavernous malformations (BSCM) present significant surgical challenges.
  • Minimally invasive techniques are crucial for resecting BSCM while minimizing surgical corridors.

Purpose of the Study:

  • To evaluate the role and safety of neuroendoscopy in the surgical resection of brainstem cavernous malformations.
  • To assess the impact of endoscopic techniques on resection extent and patient outcomes.

Main Methods:

  • Retrospective analysis of 20 procedures in 19 patients undergoing BSCM resection (2010-2020).
  • Neuroendoscopy was utilized in all cases, with corticotomy volumetry compared to cavernoma dimensions.
  • Intraoperative video documentation and radiological studies were reviewed.

Main Results:

  • Neuroendoscopy was feasible in all procedures, with no related complications.
  • Gross-total resection was achieved in 95% of cases.
  • 80% of patients showed improved or stable conditions post-surgery, with 61.1% further improving at 12 months.

Conclusions:

  • Endoscopic techniques are safe and valuable adjuncts for BSCM resection.
  • Combining neuroendoscopy with neuronavigation may optimize brainstem corticotomy size.
  • Neuroendoscopy facilitates precise preparation and resection of brainstem cavernous malformations.