Microsurgical resection of a medullary cavernous malformation through a far lateral approach

Santiago Gomez-Paz, MD, Kimberly P. Kicielinski, MD, Ajith Thomas, MD, and Christopher S. Ogilvy, MD

Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

Abstract
The decision to resect a cavernous malformation of the brainstem is based on patient- and lesion-specific factors. The patient’s age, comorbidities, neurologic condition, and number and severity of symptomatic hemorrhages are crucial to consider.1,3,5 The proximity to the brainstem surface, amount of hematoma, and true lesion size help dictate the surgical corridor.2,4 We present a patient with a medullary cavernous malformation who had three hemorrhages and neurologic worsening. The surgical approach was based on detailed preoperative imaging. We performed a far lateral posterior fossa exposure to resect the lesion. The details of surgical planning and the microsurgery are presented.


**Intro music: "Daybreak" by Graeme Rosner

iMovie,microsurgery,medulla,cavernous malformation,posterior fossa,far lateral approach,brainstem,cavernoma,vascular malformation,Journal of Neurosurgery,AANS,Neurosurgical Focus,