The Posterior Median Sulcus Approach to a Cavernoma of the Medullar Oblongata: A Step-by-Step Video Guide

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY World neurosurgery Pub Date : 2025-02-27 DOI:10.1016/j.wneu.2025.123839

Mao Vásquez , Luis J. Saavedra , Alejandro Apaza , Yelimer Caucha , Miguel Lozano , Evelyn J. Vela Rojas , Jhon Vargas , Daniel Cuya , Dennis S. Heredia , William W. Lines-Aguilar

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Abstract

Objective

Cavernous malformations of the brainstem often cause severe morbidity and mortality. The literature is limited regarding the optimal surgical approach.1, 2, 3 Our objective is to demonstrate successful use of the posterior median sulcus to access cavernous malformations of the brainstem.

Methods

We present the case of a 20-year-old woman with an exophytic cavernous malformation of the brainstem⁴^,⁵ showing signs of acute bleeding. The lesion, located near the ventricle surface, was successfully excised with entry through the posterior median sulcus.

Results

The patient sustained a mild postoperative weakness but no bulbar symptoms. Complete resection was confirmed on magnetic resonance imaging.

Conclusions

The posterior median sulcus is a safe route for exophytic lesions of the medulla.

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目的：脑干海绵状畸形（BSCM）常引起严重的发病率和死亡率。关于最佳手术入路的文献有限。我们的目的是证明成功使用后正中沟进入BSCM。方法：我们提出的情况下，20岁的妇女外生性海绵样畸形的脑干表现出急性出血的迹象。病变位于脑室表面附近，通过后正中沟进入成功切除。结果：患者术后轻度虚弱，无球部症状。MRI证实完全切除。结论：后正中沟是治疗髓质外生性病变的安全途径。

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS