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Da Li, Shu-Yu Hao, Jie Tang, Xin-Ru Xiao, Gui-Jun Jia, Zhen Wu, Li-Wei Zhang, and Jun-Ting Zhang

physiological features of CMs, which typically displace rather than invade neurostructures; these ideas have also been stated in other studies. 2 , 6 Recently, Braga et al. 12 reported 2 new infantile brainstem CMs with satisfactory outcomes similar to other infantile cases. 20 , 24 , 25 , 31 , 40 TABLE 7: Comparison of studies exclusively dedicated to surgically treated pediatric brainstem cavernous malformation * Authors & Year No. of Pts Mean Age (yrs) M/F Ratio Mean Lesion Size (cm) % w/ GTR FU (yrs) No. of Pts

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Philipp Dammann, Annika Herten, Alejandro N. Santos, Laurèl Rauschenbach, Bixia Chen, Marvin Darkwah Oppong, Börge Schmidt, Michael Forsting, Christoph Kleinschnitz, and Ulrich Sure

recurrent symptomatic hemorrhage and associated functional impairment . World Neurosurg . 2016 ; 91 : 73 – 80 . 9 Gross BA , Batjer HH , Awad IA , . Brainstem cavernous malformations: 1390 surgical cases from the literature . World Neurosurg . 2013 ; 80 ( 1-2 ): 89 – 93 . 10 Kearns KN , Chen CJ , Tvrdik P , . Outcomes of surgery for brainstem cavernous malformations: a systematic review . Stroke . 2019 ; 50 ( 10 ): 2964 – 2966 . 11 Li D , Wu ZY , Liu PP , . Natural history of brainstem cavernous malformations: prospective hemorrhage

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Taichi Kin, Hirofumi Nakatomi, Masaaki Shojima, Minoru Tanaka, Kenji Ino, Harushi Mori, Akira Kunimatsu, Hiroshi Oyama, and Nobuhito Saito

I nteractive visualization is a branch of graphics in computer science that involves the creation of graphic illustrations of information and human interactions with computers, with a focus on how this process can be made more efficient. Because surgical treatment of brainstem cavernous malformations is one of the most difficult neurosurgical operations, 20 , 34 careful preoperative examination is crucial. 5 , 24 Many surgical approaches can be applied to brainstem cavernous malformations, so the surgical approach should be determined after detailed

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Da Li, Yang Yang, Shu-Yu Hao, Liang Wang, Jie Tang, Xin-Ru Xiao, Hui Zhou, Gui-Jun Jia, Zhen Wu, Li-Wei Zhang, and Jun-Ting Zhang

, 2008 3 Abla AA , Lekovic GP , Garrett M , Wilson DA , Nakaji P , Bristol R , : Cavernous malformations of the brainstem presenting in childhood: surgical experience in 40 patients . Neurosurgery 67 : 1589 – 1599 , 2010 4 Abla AA , Lekovic GP , Turner JD , de Oliveira JG , Porter R , Spetzler RF : Advances in the treatment and outcome of brainstem cavernous malformation surgery: a single-center case series of 300 surgically treated patients . Neurosurgery 68 : 403 – 415 , 2011 5 Abla AA , Turner JD , Mitha AP

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Roxanna M. Garcia, Taemin Oh, Tyler S. Cole, Benjamin K. Hendricks, and Michael T. Lawton

E volving surgical perspectives have transformed the brainstem cavernous malformation (BSCM) from an inoperable lesion in a surgical no man’s land to a lesion that is best managed microsurgically using skull base approaches and the lesion’s presentation on pial or ependymal surfaces to access it safely while avoiding neural tracts and cranial nerve (CN) nuclei. Several systematic reviews of BSCMs describing the natural history and management of these lesions 1–3 have established microsurgical resection as the standard of care following symptomatic hemorrhage

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Wael F. Asaad, Brian P. Walcott, Brian V. Nahed, and Christopher S. Ogilvy

, : Natural history of brainstem cavernous malformations . Neurosurgery 48 : 47 – 54 , 2001 34 MacDonald JD , Antonelli P , Day AL : The anterior subtemporal, medial transpetrosal approach to the upper basilar artery and ponto-mesencephalic junction . Neurosurgery 43 : 84 – 89 , 1998 35 Maeder P , Gudinchet F , Meuli R , de Tribolet N : Development of a cavernous malformation of the brain . AJNR Am J Neuroradiol 19 : 1141 – 1143 , 1998 36 Mathiesen T , Edner G , Kihlström L : Deep and brainstem cavernomas: a consecutive 8-year

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Ephraim W. Church and Gary K. Steinberg

Transcript In this operative technique video we demonstrate microsurgical laser resection of brainstem cavernous malformations in 3 example cases. We started using the CO 2 laser for eloquent cavernomas in 2009. Over the past decade at Stanford more than 120 brainstem cavernomas have been treated with laser microsurgery with good results (Pandey et al, 2013). 0:46 Advantages of laser cavernoma removal. In the following videos we demonstrate several advantages of laser over traditional microsurgery techniques. These include improved visualization in narrow

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Abdulfettah Tumturk, Yiping Li, Yahya Turan, Ulas Cikla, Bermans J. Iskandar, and Mustafa K. Baskaya

H istorically , brainstem cavernous malformations (CMs) have been remarkably challenging to neurosurgeons. Because of their deep-seated location and high surgical risks, conservative therapy has been the mainstay of treatment for many decades. Recently, with advances in our understanding of surgical anatomy, in microsurgical techniques, and in neurophysiological monitoring modalities, overall success in treating what were traditionally deemed “unresectable” lesions has been more promising. As our understanding of CMs has evolved, we have come to realize that

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Adib A. Abla, Jay D. Turner, Alim P. Mitha, Gregory Lekovic, and Robert F. Spetzler

C avernous malformations are low-flow vascular lesions thought to be related to capillary telangiectasias and developmental venous anomalies. 1 They are found throughout the CNS, with a minority of these lesions occurring in the brainstem. Cavernous malformations were once considered to be congenital lesions; however, it is now well established that these lesions also form de novo. 8 , 10 , 13 , 16 , 18 Cavernous malformations located in the brainstem are particularly difficult to treat, given their location in eloquent tissue. Brainstem CMs can be found

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Bradley A. Gross, Ian F. Dunn, Rose Du, and Ossama Al-Mefty

.digitalsource-na-regional/focus12-110_video.asx (Media Player). http://mfile.akamai.com/21488/mov/digitalwbc.download.akamai.com/21492/qt.digitalsource-global/focus12-110_video.mov (Quicktime). References 1 Abla AA , Lekovic GP , Turner JD , de Oliveira JG , Porter R , Spetzler RF : Advances in the treatment and outcome of brainstem cavernous malformation surgery: a single-center case series of 300 surgically treated patients . Neurosurgery 68 : 403 – 415 , 2011 2 Aiba T , Tanaka R , Koike T , Kameyama S , Takeda N , Komata T : Natural history