caa a22 4500 445355727 CHVBK 20180317142859.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10072-011-0477-8 doi (NATIONALLICENCE)springer-10.1007/s10072-011-0477-8 Surgical management of brainstem cavernous malformations [Elektronische Daten] [Ricardo Ramina, Tobias Mattei, Paulo de Aguiar, Murilo Meneses, Vinicius Ferraz, Rogério Aires, Dierk Kirchhoff, Daniel de Carvalho Kirchhoff] Bleeding from brainstem cavernomas may cause severe deficits due to the absence of non-eloquent nervous tissue and the presence of several ascending and descending white matter tracts and nerve nuclei. Surgical removal of these lesions presents a challenge to the most surgeons. The authors present their experience with the surgical treatment of 43 patients with brainstem cavernomas. Important aspects of microsurgical anatomy are reviewed. The surgical management, with special focus on new intraoperative technologies as well as controversies on indications and timing of surgery are presented. According to several published studies the outcome of brainstem cavernomas treated conservatively is poor. In our experience, surgical resection remains the treatment of choice if there was previous hemorrhage and the lesion reaches the surface of brainstem. These procedures should be performed by experienced neurosurgeons in referral centers employing all the currently available technology. Springer-Verlag, 2011 Cavernous malformation nationallicence Brainstem nationallicence Vascular malformation nationallicence Surgery nationallicence Microsurgical anatomy nationallicence Cavernomas nationallicence Ramina Ricardo Neurosurgical Department, Neurological Institute of Curitiba, Jeremias Maciel Perreto 300, 81210-310, Curitiba, PR, Brazil aut Mattei Tobias Neurosurgical Department, Neurological Institute of Curitiba, Jeremias Maciel Perreto 300, 81210-310, Curitiba, PR, Brazil aut de Aguiar Paulo Neurosurgical Department, Santa Paula Hospital, São Paulo, Brazil aut Meneses Murilo Neurosurgical Department, Neurological Institute of Curitiba, Jeremias Maciel Perreto 300, 81210-310, Curitiba, PR, Brazil aut Ferraz Vinicius Neurosurgical Department, Neurological Institute of Curitiba, Jeremias Maciel Perreto 300, 81210-310, Curitiba, PR, Brazil aut Aires Rogério Neurosurgical Department, Santa Paula Hospital, São Paulo, Brazil aut Kirchhoff Dierk Neurosurgical Department of Assistência Neurológica de São Bernardo do Campo, São Paulo, Brazil aut de Carvalho Kirchhoff Daniel Neurosurgical Department of Assistência Neurológica de São Bernardo do Campo, São Paulo, Brazil aut Neurological Sciences Springer Milan 32/6(2011-12-01), 1013-1028 1590-1874 32:6<1013 2011 32 10072 https://doi.org/10.1007/s10072-011-0477-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10072-011-0477-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ramina Ricardo Neurosurgical Department, Neurological Institute of Curitiba, Jeremias Maciel Perreto 300, 81210-310, Curitiba, PR, Brazil aut NATIONALLICENCE 700 1- Mattei Tobias Neurosurgical Department, Neurological Institute of Curitiba, Jeremias Maciel Perreto 300, 81210-310, Curitiba, PR, Brazil aut NATIONALLICENCE 700 1- de Aguiar Paulo Neurosurgical Department, Santa Paula Hospital, São Paulo, Brazil aut NATIONALLICENCE 700 1- Meneses Murilo Neurosurgical Department, Neurological Institute of Curitiba, Jeremias Maciel Perreto 300, 81210-310, Curitiba, PR, Brazil aut NATIONALLICENCE 700 1- Ferraz Vinicius Neurosurgical Department, Neurological Institute of Curitiba, Jeremias Maciel Perreto 300, 81210-310, Curitiba, PR, Brazil aut NATIONALLICENCE 700 1- Aires Rogério Neurosurgical Department, Santa Paula Hospital, São Paulo, Brazil aut NATIONALLICENCE 700 1- Kirchhoff Dierk Neurosurgical Department of Assistência Neurológica de São Bernardo do Campo, São Paulo, Brazil aut NATIONALLICENCE 700 1- de Carvalho Kirchhoff Daniel Neurosurgical Department of Assistência Neurológica de São Bernardo do Campo, São Paulo, Brazil aut NATIONALLICENCE 773 0- Neurological Sciences Springer Milan 32/6(2011-12-01), 1013-1028 1590-1874 32:6<1013 2011 32 10072 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer