Endoscopic Endonasal Transclival Resection of a Brainstem Cavernoma: A Detailed Account of Our Technique and Comparison with the Literature

World Neurosurgery
Stefan Linsler, Joachim Oertel

Abstract

To report a technique of endoscopic transclival resection of a hemorrhagic brainstem cavernous malformation manifesting in the ventral pons. A 29-year-old woman presented with numbness and tingling of the right arm and leg and loss of fine motor control. Magnetic resonance imaging revealed a cavernoma in the ventromedial brainstem on the ventral surface. A purely endoscopic, endonasal, transclival approach was used to resect this cavernoma. Computed tomography/magnetic resonance imaging merged navigation (StealthStation, Medtronic) was used. The patient had no neurologic deficits postoperatively. The motor control loss and tingling disappeared. She did not experience any complications. Cerebrospinal fluid leakage appeared to result from using the very small opening of the skull base and dura mater and was the reason for the use of a lumbar drain for several days. At the 6-week follow-up examination, the patient was in excellent condition with no neurologic deficits and had returned to her full-time job. Successful endoscopic, endonasal, transclival resection of a brainstem cavernous malformation was described. This patient experienced improvement in neurologic symptoms after surgery without morbidity. Technologic advances in en...Continue Reading

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Citations

Apr 27, 2016·Journal of Neurosciences in Rural Practice·Stefan Linsler
Oct 22, 2016·Journal of Neurosurgery·Juan Luis Gómez-AmadorAlfredo Vega-Alarcón
Oct 21, 2016·World Neurosurgery·Dmitry FomichevAndrey Gavrushin
Jan 14, 2017·Journal of Neurosurgery·Walid I EssayedTheodore H Schwartz
Dec 2, 2017·British Journal of Neurosurgery·Puya AlikhaniSiviero Agazzi
Jul 14, 2019·Operative Neurosurgery·Daniel G EichbergRobert M Starke
Aug 1, 2019·American Journal of Rhinology & Allergy·Philip G ChenLeonid Bunegin
Dec 14, 2019·Operative Neurosurgery·Mina M GergesTheodore H Schwartz
Sep 19, 2019·Neurosurgical Review·Joachim OertelStefan Linsler
Feb 16, 2020·Neurosurgical Review·Francesco BelottiFrancesco Doglietto
Mar 15, 2018·Operative Neurosurgery·David T Fernandes CabralJuan C Fernandez-Miranda
Feb 2, 2020·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Ali KaradagNecmettin Tanriover

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