Thalamomesencephalic cavernoma: anterior transcallosal transchoroidal approach

Area of Science:

• Neurosurgery
• Neurology
• Vascular Neurosurgery

Background:

• Thalamomesencephalic cavernomas are rare vascular malformations.
• Bleeding from these lesions can cause significant neurological deficits.

Purpose of the Study:

• To present a case of a bleeding thalamomesencephalic cavernoma.
• To describe the surgical technique for its removal using an anterior transcallosal transchoroidal approach.
• To evaluate the efficacy and safety of this surgical approach.

Main Methods:

• A 62-year-old male patient presented with acute diplopia, headache, and vomiting due to a bleeding thalamomesencephalic cavernoma.
• The lesion was surgically resected via an anterior transcallosal transchoroidal interhemispheric approach.
• The surgical steps included craniotomy, splitting the interhemispheric fissure, callosotomy, and opening the choroidal fissure.

Main Results:

• The thalamomesencephalic cavernoma was successfully identified and resected.
• The patient experienced no long-term postoperative neurological deficits.
• The anterior transcallosal transchoroidal approach proved to be a viable surgical option.

Conclusions:

• The anterior transcallosal transchoroidal approach is an effective and safe method for resecting thalamomesencephalic cavernomas.
• This surgical technique offers a valid alternative for treating lesions in this challenging anatomical location.
• Minimizing neurological deficits is achievable with meticulous surgical planning and execution.