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Posterior Transtemporal Approach to a Thalamic Cavernous Malformation: 2-Dimensional Operative Video.
Biondi-Soares, Luis Gustavo; Gomes Galvão da Trindade, Érico Samuel; Apaza-Tintaya, Rene Alejandro; Canache Jiménez, Luis Ángel; Pereira, Felipe Salvagni; Teixeira Soto Iscal, Pedro Henrique; Vilcahuamán Paitán, Alexander Feliciano; Tenelema Aguaisa, Edgar David; Chaddad-Neto, Feres.
Afiliação
  • Biondi-Soares LG; Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, São Paulo, Brazil.
  • Gomes Galvão da Trindade ÉS; Department of Neurosurgery, Federal University of Paraná, Curitiba, Paraná, Brazil.
  • Apaza-Tintaya RA; Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, São Paulo, Brazil.
  • Canache Jiménez LÁ; Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, São Paulo, Brazil.
  • Pereira FS; Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, São Paulo, Brazil.
  • Teixeira Soto Iscal PH; Irmandade Nossa Senhora das Mercês de Montes Claros, Hospital Santa Casa de Montes Claros, Minas Gerais, Minas Gerais, Brazil.
  • Vilcahuamán Paitán AF; Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, São Paulo, Brazil.
  • Tenelema Aguaisa ED; Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, São Paulo, Brazil.
  • Chaddad-Neto F; Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, São Paulo, Brazil; Department of Neurosurgery, Hospital Beneficência Portuguesa de São Paulo, São Paulo, São Paulo, Brazil. Electronic address: fereschaddad@hotmail.com.
World Neurosurg ; 185: 72-73, 2024 05.
Article em En | MEDLINE | ID: mdl-38342174
ABSTRACT
Cavernous malformations (CMs) account for 10%-15% of all vascular malformations and represent the second most common type of cerebral vascular lesion.1 They typically occur in the cerebral subcortex or white matter.2 CMs located in the thalamus are rare.3 When we isolate the group of thalamic CMs, we find a bleeding risk of >5% per year, with a rebleeding rate exceeding 60%, often occurring within 1 year of the initial bleeding.1 The deep location and proximity to eloquent brain regions make thalamic CMs challenging for neurosurgeons.4,5 Surgeons can access the posterolateral thalamus through various surgical approaches, such as transcallosal transventricular, supracerebellar transtentorial, intraparietal sulcus, and transcortical methods. Selecting the best surgical approach requires considerable expertise, considering the patient's preoperative condition and the lesion's location.6-12 We discuss a complex case involving a 24-year-old patient with a right thalamic cavernoma and a history of 3 prior bleeding events. We present a step-by-step transcortical approach through the posterior portion of the superior temporal gyrus (Video 1). The patient consented to the procedure and publication of images. We demonstrate how the transtemporal posterior trajectory provides an optimal working corridor for safely removing this cavernous malformation without introducing new deficits.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tálamo / Procedimentos Neurocirúrgicos / Hemangioma Cavernoso do Sistema Nervoso Central Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tálamo / Procedimentos Neurocirúrgicos / Hemangioma Cavernoso do Sistema Nervoso Central Idioma: En Ano de publicação: 2024 Tipo de documento: Article