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Microsurgical Resection of a Left Temporal Stem Cavernous Malformation Through Transsylvian Approach: 2-Dimensional Operative Video.
Sarti, Talita Helena Martins; Jiménez, Luis Ángel Canache; Kim, Isaque Hyung Tong; ApazaTintaya, René Alejandro; Linné, Michel; Wuo-Silva, Raphael; Chaddad-Neto, Feres.
Afiliação
  • Sarti THM; Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Jiménez LÁC; Neurosurgery, Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil.
  • Kim IHT; Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • ApazaTintaya RA; Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Linné M; Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Wuo-Silva R; Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Chaddad-Neto F; Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Oper Neurosurg (Hagerstown) ; 2024 May 21.
Article em En | MEDLINE | ID: mdl-38771090
ABSTRACT
Cavernous malformations (CMs) are rare, often oligosymptomatic vascular lesions. Common manifestations include seizures and focal neurological deficits. Depending on the symptoms, location, size, and risk factors of bleeding, such as the presence of a developmental venous anomaly, the injury can be highly morbid. Hence, one can consider surgical resection. Deep and eloquently located CMs, such as those located in the temporal trunk, can be quite challenging and require an exact operative technique.1-7 We present a 27-year-old patient with a history of headaches that began two years ago and significantly worsened in the last month, associated with visual blurring, scotomas, nausea, phonophobia, and photophobia as well as paresthesias in the hands and perioral region. Imaging investigation revealed a CM in the temporal stem (Zabramski classification II). Owing to the risk of rebleeding and the young age, surgical resection was performed using a transsylvian approach to preserve the temporal cortex. We describe the technique applied and demonstrate the necessary care manipulating the distal sylvian fissure and the superficial sylvian veins. We also detail the anatomy of the temporal stem and the benefit of the transsylvian approach to preserve the white matter fibers that compose the temporal stem. The patient consented to the procedure and to the publication of his/her image. This study was approved by the Ethics Committee of our institution. Performed CM resection using the transsylvian pterional craniotomy technique, and it proceeded without complications. The postoperative period was also uneventful. The postoperative imaging demonstrated total resection of the cavernoma.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Oper Neurosurg (Hagerstown) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Oper Neurosurg (Hagerstown) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos