Microsurgical resection of a midbrain cavernous malformation via the paramedian supracerebellar infratentorial trans-lateral mesencephalic sulcus approach using the dynamic lateral semi-sitting position: 2-dimensional operative video with 3D anatomical models

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dc.contributor.authorBulgur, Feride
dc.contributor.authorFidan, Semih
dc.contributor.authorBağcı, Seyhun
dc.contributor.authorGökalp, Elif
dc.contributor.authorLuzzi, Sabino
dc.contributor.authorGüngör, Abuzer
dc.date.accessioned2025-01-15T07:34:51Z
dc.date.available2025-01-15T07:34:51Z
dc.date.issued2025en_US
dc.departmentFakülteler, Tıp Fakültesien_US
dc.description.abstractBrainstem cavernous malformations are relatively rare lesions with a higher tendency of hemorrhage than supratentorial cavernous malformations. Due to the compact arrangement of fiber tracts and nuclei of the region, any hemorrhagic event can cause severe neurological deficits. This eloquent architecture of the area also makes any surgical attempt challenging. Anatomical location and dimension of the lesion, presence of hemorrhage, age, and the neurological status of the patient need to be considered before determining the appropriate course of treatment. A surgical approach is preferred for young symptomatic patients with at least 1 previous episode of bleeding. Subtemporal and supracerebellar infratentorial approaches can be used to access these lesions.1-5 We present a 44-year-old woman with a hemorrhagic tegmental cavernous malformation presenting with imbalance and right-sided hemiparesis (Video 1). The paramedian supracerebellar infratentorial translateral mesencephalic sulcus approach is used to resect the lesion with the patient in a dynamic lateral semisitting position. The paramedian variant of the supracerebellar infratentorial approach provides a relatively bridging vein-free corridor compared with midline approaches.6 With the patient in the semisitting position, gravity retraction of the brain provided a natural corridor with a clear surgical field. In the dynamic lateral semisitting position, we aimed to reduce the risk of venous air embolism associated with the sitting position by keeping the patient in the lateral decubitus position during the dural and extradural phases of the surgery.en_US
dc.identifier.citationBulgur, F., Fidan, S., Bağcı, S., Gökalp, E., Luzzi, S., Güngör, A. (2025). Microsurgical resection of a midbrain cavernous malformation via the paramedian supracerebellar infratentorial trans-lateral mesencephalic sulcus approach using the dynamic lateral semi-sitting position: 2-dimensional operative video with 3D anatomical models. World Neurosurgery, 195. 10.1016/j.wneu.2024.123635en_US
dc.identifier.issn1878-8750
dc.identifier.issn1878-8769
dc.identifier.pmid39756536
dc.identifier.scopus2-s2.0-85215588828
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://hdl.handle.net/20.500.12939/5151
dc.identifier.wosWOS:001408555500001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.indekslendigikaynakWeb of Science
dc.institutionauthorGüngör, Abuzer
dc.language.isoen
dc.relation.ispartofWorld Neurosurgery
dc.relation.isversionof10.1016/j.wneu.2024.123635en_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectBrainstem Cavernous Malformationen_US
dc.subjectDynamic Lateral Semi-Sitting Positionen_US
dc.subjectLateral Mesencephalic Sulcusen_US
dc.subjectSupracerebellar Infratentorial Approachen_US
dc.titleMicrosurgical resection of a midbrain cavernous malformation via the paramedian supracerebellar infratentorial trans-lateral mesencephalic sulcus approach using the dynamic lateral semi-sitting position: 2-dimensional operative video with 3D anatomical models
dc.typeArticle

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