脑研究杂志

Stereotactic Surgery for Cavernous Malformation in Eloquent Area: Alternative in Selected Cases

Abstract

William Wilson Lines-Aguilar*, Mao Vásquez, José Calderón, Yelimer Caucha, Jorge E. Medina and Luis Jose Saavedra

Introduction: Cavernous malformations (CM) are infrequent vascular lesions, generally presenting with epileptic seizures and bleeding. Symptomatic or those with recurrent bleeding should be considered for surgical removal. CM of eloquent areas usually require awake surgery; when this it is not possible, other precision instruments such as stereotactic tools can be used to plan and perform safe surgeries with good functional results.

Methods: A 36-year-old male patient presented with seizures, including an episode of status epilepticus, and recurrent bleeding. MRI revealed a left frontal opercular lesion with typical characteristics of CM, close to the primary language area. The patient did not accept awake surgery, so a stereotactic system was used to define the exact point of approach.

Results: Complete macroscopic resection of the lesion was achieved without surgical complications and without functional deficits.

Conclusion: Precision neurosurgical instruments such as the stereotactic framework and the neuronavigator, can contribute to plan surgeries when other modern technology (tomography or intraoperative resonance) is not available or when the patient does not collaborate, as in this case.