Beyin sapı kavernomalarına cerrahi yaklaşım

Usseli M. İ., Çevik O. M., Güdük M., Bozkurt B., Özduman K., Pamir M. N.

The 9th SNSS Annual Meeting and The 10th SNSS Congress, Belgrade, Sırbistan, 30 Ekim - 03 Kasım 2023

  • Yayın Türü: Bildiri / Yayınlanmadı
  • Basıldığı Şehir: Belgrade
  • Basıldığı Ülke: Sırbistan
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

Surgical approach to brainstem cavernomas.

Usseli Mİ, Çevik O, Güdük M, Bozkurt B, Özduman K, Pamir MN.

Acıbadem Mehmet Ali Aydınlar University, School of Medicine, Department of Neurosurgery, İstanbul, Turkey.

 

Background: Cavernous malformations are vascular malformations with an incidence of 0,5% in general population, comprimising 5-10% of all intracranial vascular malformations. Brainstem cavernomas have a prevelance of 4-35% among all other intracranial cavernous malformations. Brainstem cavernomas have distinct place among other intracranial cavernous malformations due to peculiar location and potential devastating events. Today, some standard surgical routes, entry zones and microsurgical techniques are known for a relatively safe operation in the brain stem. Our surgical experience and approach routes to brain stem cavernomas will be shared in this presentation.

 

Methods: This is a retrospective review from prospectively collected database of our clinic practice for last 37 years. Patient charts, cranial MRIs, pathology reports, and outpatient notes were evaluated.

 

Results: 55 patients with brainstem cavernous malformation were operated in our clinic in the last 37 years. Of these 55 patients, 26 (47%) were women and 29 (53%) were men and the mean age was 34 years (range: 18-70 years). Specfic cavernoma locations were pineal region (3,6%), thalamus (12,7%), mesencephalon (5,5%), pons (65,5%), and medulla oblongata (12,7%). Occipital interhemispheric, interhemispheric transcallosal, paramedian supracerebellar, cranioorbitozygomatic, median suboccipital, and paramedian retrosigmoid suboccipital routes were used respectively for the approach.  Mortality rate was 0%. Better or the same clinical/neurological status could be achieved in 83,6% of the patients in the long term follow up, which is consistent with the literature.

 

Conclusion: Despite demanding surgical skills for surgical approch to brainstem cavernomas, surgery could be accomplished safely and effectively in selected cases with appropriate indications. The choice of the surgical route is extremely important for a successful surgical practice in the treatment of these pathologies.