Lateral transpetrosal approaches for brainstem cavernous malformations: tailoring the operative trajectory according to lesion location. Illustrative cases.
- 1Department of Neurosurgery, Saso Hospital, Nishinomiya, Hyogo, Japan.
Abstract
Background
The authors propose a surgical strategy for the resection of lateral brainstem cavernous malformations (BSCMs) and demonstrate how the surgical corridor should be tailored according to lesion location.Observations
Three consecutive patients with lateral BSCMs underwent microsurgical resection through transpetrosal approaches. Two pontine lesions were approached through the lateral pontine zone using a posterior transpetrosal approach, whereas one upper lateral midbrain lesion required a combined transpetrosal approach to obtain a steeper upward operative trajectory through the lateral mesencephalic sulcus. Gross-total resection was achieved in all patients without new permanent neurological deficits. The posterior transpetrosal approach provided adequate exposure for pontine lesions, whereas the combined transpetrosal approach offered a more favorable upward trajectory for the upper lateral midbrain lesion.Lessons
Lateral transpetrosal approaches provide effective surgical corridors for lateral BSCMs while minimizing transgression of eloquent brainstem pathways. Selection of the posterior or combined transpetrosal approach should be tailored according to the rostrocaudal location of the lesion and the required operative trajectory. https://thejns.org/doi/10.3171/CASE26717.
Related
- Anterior transpetrosal approach for a recurrent craniopharyngioma in a pediatric patient: two-dimensional operative video
- BMP4 and WIF1 expression in mother–child pairs in relation to anorectal malformations and maternal reproductive history
- Preservation of Non-nidal Medial Veins During Microsurgical Resection of Cerebral Arteriovenous Malformations: Technical Considerations and Early Clinical Outcomes
- Beyond the Classic Triad: A Case of GQ1b Antibody-Positive Bickerstaff Brainstem Encephalitis Overlap Syndrome
- Brainstem sensing of multiple body signals during food consumption
BibTeX
@article{ohmori2026lateral,
title = {{Lateral transpetrosal approaches for brainstem cavernous malformations: tailoring the operative trajectory according to lesion location. Illustrative cases.}},
author = {Kazumi Ohmori and Taku Takeuchi and Shiduka Kamiyoshi},
journal = {Journal of neurosurgery. Case lessons},
year = {2026},
month = oct,
doi = {10.3171/case26717},
url = {https://europepmc.org/article/MED/42896237},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Lateral transpetrosal approaches for brainstem cavernous malformations: tailoring the operative trajectory according to lesion location. Illustrative cases.
AU - Kazumi Ohmori
AU - Taku Takeuchi
AU - Shiduka Kamiyoshi
PY - 2026
DA - 2026/10/19
JO - Journal of neurosurgery. Case lessons
DO - 10.3171/case26717
UR - https://europepmc.org/article/MED/42896237
AB - Background The authors propose a surgical strategy for the resection of lateral brainstem cavernous malformations (BSCMs) and demonstrate how the surgical corridor should be tailored according to lesion location.Observations Three consecutive patients with lateral BSCMs underwent microsurgical resection through transpetrosal approaches. Two pontine lesions were approached through the lateral pontine zone using a posterior transpetrosal approach, whereas one upper lateral midbrain lesion required a combined transpetrosal approach to obtain a steeper upward operative trajectory through the lateral mesencephalic sulcus. Gross-total resection was achieved in all patients without new permanent neurological deficits. The posterior transpetrosal approach provided adequate exposure for pontine lesions, whereas the combined transpetrosal approach offered a more favorable upward trajectory for the upper lateral midbrain lesion.Lessons Lateral transpetrosal approaches provide effective surgical corridors for lateral BSCMs while minimizing transgression of eloquent brainstem pathways. Selection of the posterior or combined transpetrosal approach should be tailored according to the rostrocaudal location of the lesion and the required operative trajectory. https://thejns.org/doi/10.3171/CASE26717.
SN - 2694-1902
ER -