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Electrocardiogram Synchronized Physiological Feedback During Obex Cavernoma Surgery: 2-Dimensional Operative Video
Caiqiang Huang1, Jiandong Jiang1, Yuhai Bao1
1Department of Neurosurgery, Xiamen Humanity Hospital, Xiamen, Fujian, China.
World Neurosurgery
|July 3, 2026
Summary
This video shows a physiology-guided surgical strategy for removing a brainstem cavernoma causing severe symptoms. The technique uses real-time physiological monitoring to ensure safe and effective resection, leading to symptom resolution.
Area of Science:
- Neurosurgery
- Neurology
- Medical Imaging
Background:
- Brainstem cavernomas can cause severe neurological deficits.
- Surgical resection is challenging due to proximity to critical structures.
- Physiological monitoring can guide intraoperative decision-making.
Purpose of the Study:
- To present a physiology-guided surgical strategy for obex cavernoma resection.
- To demonstrate the utility of ECG-synchronized cardioinhibitory responses in neurosurgery.
- To illustrate a safe approach for brainstem lesion removal.
Main Methods:
- Midline suboccipital telovelar approach for resection.
- Multimodal monitoring including ECG-synchronized cardioinhibitory responses.
- Intraoperative adjustments based on physiological feedback.
Main Results:
- Gross-total resection of the right paramedian obex cavernoma achieved.
- Complete resolution of preoperative symptoms including dysphagia and hoarseness.
- Preservation of the associated developmental venous anomaly and no new neurological deficits.
Conclusions:
- A physiology-guided strategy can facilitate safe and effective resection of brainstem cavernomas.
- ECG-synchronized cardioinhibitory responses are valuable for intraoperative neuromonitoring.
- Surgical intervention can lead to significant improvement in patients with symptomatic obex cavernomas.
