Neurosurg Focus (Suppl) 36:Video 1, 2014
Resection of pontine cavernous malformation through the pontomedullary sulcus Adib Adnan Abla, M.D., Aaron J. Clark, M.D., Ph.D. and Michael T. Lawton, M.D. University of California, San Francisco, Neurosurgery, San Francisco, California In this video, we illustrate a right far-lateral craniotomy for resection of a 13-mm cavernous malformation of the pons in a healthy 53-year-old female patient presenting with diplopia and right 6th nerve palsy. The cavernous malformation was surrounded by normal pons, but was within 1 mm of the pontomedullary sulcus. The lesion was exposed from below through a far lateral craniotomy and accessed through the vasoaccessory triangle, superior to olivary nucleus and 12th cranial nerve. The alternative retrosigmoid craniotomy would have involved significant transgression of the middle cerebellar peduncle. The patient had gross-total resection and some temporary increase in her abducens nerve palsy without any complication. The video can be found here: http://youtu.be/f14RR3CHQkw. (http://thejns.org/doi/abs/10.3171/2014.V1.FOCUS13442)
Key Words • cavernous malformation • pontine • pontomedullary sulcus • nerve • video
Manuscript submitted September 30, 2013. Accepted November 1, 2013. Please include this information when citing this paper: DOI: 10.3171/2014.V1.FOCUS13442. Address correspondence to: Michael T. Lawton, M.D., University of California, San Francisco, Neurosurgery, 505 Parnassus Avenue, M780, San Francisco, CA 94143-0112. email: lawtonm@neurosurg. ucsf.edu.
Neurosurg Focus / Volume 36 / January 2014
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