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Retrosigmoid suprafloccular transhorizontal fissure approach for resection of brainstem cavernous malformation.

Publication ,  Journal Article
Ohue, S; Fukushima, T; Friedman, AH; Kumon, Y; Ohnishi, T
Published in: Neurosurgery
June 2010

OBJECTIVE: This study examined the usefulness of a surgical approach (retrosigmoid suprafloccular transhorizontal fissure approach) for resection of brainstem cavernous malformations (CMs). METHODS: An anatomic study concerning the retrosigmoid suprafloccular transhorizontal fissure approach was performed with 3 cadaveric heads. Clinical course was retrospectively reviewed for 10 patients who underwent microsurgical resection of brainstem CMs with this approach. Medical, surgical, and neuroimaging records of these patients were evaluated. RESULTS: In the anatomic study, after standard suboccipital retrosigmoid craniotomy, the horizontal fissure on the petrosal surface of the cerebellum was dissected between the superior semilunar lobule and flocculus. With this approach, the root entry zone of the trigeminal nerve and the middle cerebellar peduncle could be exposed by superior retraction of the superior semilunar lobule. The lateral surface of the pons was then easily visible around the root entry zone. When this approach was used for 10 brainstem CMs, complete resection was achieved in 9 patients (90%). No mortality was encountered in this study. New neurological deficits occurred in the early postoperative period for 4 patients but were transient in 3 patients. Neurological status at final follow-up was improved in 4 patients (40%), unchanged in 5 patients (50%), and worse in 1 patient (10%) compared with preoperative conditions. CONCLUSION: The retrosigmoid suprafloccular transhorizontal fissure approach is useful for the resection of lateral pontine CMs.

Duke Scholars

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

June 2010

Volume

66

Issue

6 Suppl Operative

Start / End Page

306 / 312

Location

United States

Related Subject Headings

  • Young Adult
  • Vascular Surgical Procedures
  • Retrospective Studies
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Hemangioma, Cavernous, Central Nervous System
  • Female
 

Citation

APA
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ICMJE
MLA
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Ohue, S., Fukushima, T., Friedman, A. H., Kumon, Y., & Ohnishi, T. (2010). Retrosigmoid suprafloccular transhorizontal fissure approach for resection of brainstem cavernous malformation. Neurosurgery, 66(6 Suppl Operative), 306–312. https://doi.org/10.1227/01.NEU.0000369703.67562.BB
Ohue, Shiro, Takanori Fukushima, Allan H. Friedman, Yoshiaki Kumon, and Takanori Ohnishi. “Retrosigmoid suprafloccular transhorizontal fissure approach for resection of brainstem cavernous malformation.Neurosurgery 66, no. 6 Suppl Operative (June 2010): 306–12. https://doi.org/10.1227/01.NEU.0000369703.67562.BB.
Ohue S, Fukushima T, Friedman AH, Kumon Y, Ohnishi T. Retrosigmoid suprafloccular transhorizontal fissure approach for resection of brainstem cavernous malformation. Neurosurgery. 2010 Jun;66(6 Suppl Operative):306–12.
Ohue, Shiro, et al. “Retrosigmoid suprafloccular transhorizontal fissure approach for resection of brainstem cavernous malformation.Neurosurgery, vol. 66, no. 6 Suppl Operative, June 2010, pp. 306–12. Pubmed, doi:10.1227/01.NEU.0000369703.67562.BB.
Ohue S, Fukushima T, Friedman AH, Kumon Y, Ohnishi T. Retrosigmoid suprafloccular transhorizontal fissure approach for resection of brainstem cavernous malformation. Neurosurgery. 2010 Jun;66(6 Suppl Operative):306–312.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

June 2010

Volume

66

Issue

6 Suppl Operative

Start / End Page

306 / 312

Location

United States

Related Subject Headings

  • Young Adult
  • Vascular Surgical Procedures
  • Retrospective Studies
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Hemangioma, Cavernous, Central Nervous System
  • Female