The Posterior Median Sulcus Approach to a Cavernoma of the Medullar Oblongata: A Step-by-Step Video Guide.

Abstract

Cavernous malformations of the brainstem often cause severe morbidity and mortality. The literature is limited regarding the optimal surgical approach.^1-3 Our objective is to demonstrate successful use of the posterior median sulcus to access cavernous malformations of the brainstem. We present the case of a 20-year-old woman with an exophytic cavernous malformation of the brainstem⁴^,⁵ showing signs of acute bleeding. The lesion, located near the ventricle surface, was successfully excised with entry through the posterior median sulcus. The patient sustained a mild postoperative weakness but no bulbar symptoms. Complete resection was confirmed on magnetic resonance imaging. The posterior median sulcus is a safe route for exophytic lesions of the medulla.