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Published on: October 20, 2017
Brainstem cavernous malformations in pediatrics: case report and literature review
Antonio Heredia-Gutiérrez1,2, María E Carbarín-Carbarín3
1Servicio de Neurocirugía Pediátrica, Hospital para el Niño Poblano, San Andrés Cholula.
Insights
Cavernous malformations in the brainstem are rare in children. Surgical resection of a symptomatic brainstem cavernous malformation in a pediatric patient led to complete symptom resolution, highlighting surgery as a viable treatment.
Area of Science:
- Neurology
- Neurosurgery
- Pediatrics
Background:
- Cavernous malformations (CMs) affect 0.4%-0.8% of the population.
- Symptoms include seizures, headaches, and neurological deficits.
- Brainstem CMs in pediatric patients are infrequent.
Purpose of the Study:
- To report a case of a pediatric patient with a brainstem cavernous malformation.
- To discuss the management and outcomes of brainstem CMs in children.
Main Methods:
- Case presentation of a 10-year-old girl with neurological deficits.
- Diagnostic imaging using magnetic resonance imaging (MRI) of the brain.
- Surgical resection of the pontobulbar lesion.
Main Results:
- The patient presented with headache, right hemiparesis, ataxia, and cranial nerve deficits (VI, VII, IX, X).
- MRI revealed a left pontobulbar lesion consistent with a cavernous malformation.
- One year post-surgery, the patient experienced complete resolution of symptoms.
Conclusions:
- Surgical resection is recommended for symptomatic brainstem cavernous malformations in pediatric patients.
- Neurological surveillance is appropriate for asymptomatic lesions.
- This case underscores the efficacy of surgical intervention for pediatric brainstem CMs.
Abstract:
Cavernous malformations have a prevalence of 0.4% to 0.8% in the population. Its symptoms are seizures, headache, and motor and cranial nerve deficits. We present the case of a 10-year-old girl with headache, right hemiparesis, ataxia, and involvement of left cranial nerves VI, VII, IX and X. Magnetic resonance imaging of the brain showed a left pontobulbar lesion. A cavernous malformation was resected. The patient showed resolution of the symptoms one year after surgery. Cavernous malformations of the brainstem in pediatrics are infrequent; when they bleed, surgery is recommended, and in asymptomatic lesions only neurological surveillance.
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