[Brain Stem and Para-Brain Stem Lesions]

Area of Science:

• Neurosurgery
• Surgical Oncology
• Neurology

Context:

• Brainstem surgeries are complex due to the deep surgical field and high complication risks.
• Limited surgical experience and reduced tissue mobility in the brainstem pose significant challenges.
• Optimal surgical approach selection is critical for successful brainstem lesion resection.

Purpose:

• To evaluate the effectiveness of preoperative simulation in brainstem surgeries.
• To highlight the importance of integrating intraoperative data with preoperative planning.
• To demonstrate successful application of simulation in diverse brainstem lesion cases.

Summary:

• Preoperative simulation, despite limitations with small vessels and nerves, can be effective for brainstem surgeries.
• The study presents three cases: brainstem cavernous hemangioma, trochlear schwannoma, and diffuse midline glioma.
• Combining simulation with intraoperative observations and monitoring is crucial for surgical strategy.

Impact:

• Preoperative simulation can enhance surgical planning and potentially reduce complications in challenging brainstem procedures.
• This approach may improve the ability of surgeons to manage deep-seated brain lesions.
• Case examples illustrate the practical benefits of simulation in neurosurgical oncology and treatment of cranial nerve tumors.