Introduction. Cavernous malformations localized in the brain stem are
considered as a separate entity in relation to other intracranial cavernoma.
Clinical presentation is specific in terms of focal neurologic deficit, they
show aggressive biological behavior and unfavorable clinical course, whereas
localization in the brain stem naturally represents the largest surgical
problem and challenge and significantly higher operational risk. Results. We
report a series of 10 patients with brainstem cavernoma, operated at the
Department of Neurosurgery, Clinical Center of Serbia in the period of
2008-2012. In cavernous lesions of the dorsal pons and upper cerebellar
peduncul we used the approach through the fourth ventricule, in the laterally
localized pontine cavernoma we used the cerebellopontine angle approach, in
the cavernoma localized in the central midbrain tegmental area was used
supreacerebellar infratentorially approach. Conclusion. Surgical removal of
the brainstem cavernoma is absolutely expedient both from the standpoint of
preventing recurrent and debilitating hemorrhage and in terms of recovery of
neurologic deficit. In patients with disturbed vital functions, the
evacuation of the hematoma and removal of the malformation eliminate
compression of effects on vital structures of the brain stem.
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