{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T07:30:57Z","timestamp":1785569457327,"version":"3.56.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2010,9]]},"abstract":"<jats:p>Brainstem cavernous malformations (CMs) are low-flow vascular lesions in eloquent locations. Their presentation is often marked with symptomatic hemorrhages that appear to occur more frequently than hemorrhage from supratentorial cavernomas. Brainstem CMs can be removed using 1 of the 5 standard skull-base approaches: retrosigmoid, suboccipital (with or without telovelar approach), supracerebellar infratentorial, orbitozygomatic, and far lateral.<\/jats:p>\n                  <jats:p>Patients being referred to a tertiary institution often have lesions that are aggressive with respect to bleeding rates. Nonetheless, the indications for surgery, in the authors' opinion, are the same for all lesions: those that are symptomatic, those that cause mass effect, or those that abut a pial surface. Patients often have relapsing and remitting courses of symptoms, with each hemorrhage causing a progressive and stepwise decline. Many patients experience new postoperative deficits, most of which are transient and resolve fully. Despite the risks associated with operating in this highly eloquent tissue, most patients have had favorable outcomes in the authors' experience. Surgical treatment of brainstem CMs protects patients from the potentially devastating effects of rehemorrhage, and the authors believe that the benefits of intervention outweigh the risks in patients with the appropriate indications.<\/jats:p>","DOI":"10.3171\/2010.6.focus10128","type":"journal-article","created":{"date-parts":[[2010,9,1]],"date-time":"2010-09-01T10:23:13Z","timestamp":1283336593000},"page":"E8","source":"Crossref","is-referenced-by-count":107,"title":["Surgical approaches to brainstem cavernous malformations"],"prefix":"10.3171","volume":"29","author":[{"given":"Adib A.","family":"Abla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay D.","family":"Turner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alim P.","family":"Mitha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Lekovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Spetzler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0290008","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1007\/s00701-008-1570-5","article-title":"Developmental venous anomaly, cavernous malformation, and capillary telangiectasia: spectrum of a single disease","volume":"150","author":"Abla","year":"2008"},{"key":"b2-0290008","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1097\/00006123-199806000-00013","article-title":"Stereotactic radiosurgery for cavernous malformations: Kjellberg's experience with proton beam therapy in 98 cases at the Harvard Cyclotron","volume":"42","author":"Amin-Hanjani","year":"1998"},{"key":"b3-0290008","series-title":"BNI Q","first-page":"20","article-title":"The two-point method: evaluating brain stem lesions","volume":"12","author":"Brown","year":"1996"},{"key":"b4-0290008","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1001\/archsurg.1928.01140110002001","article-title":"Venous abnormalities and angiomas of the brain","volume":"17","author":"Dandy","year":"1928"},{"issue":"Suppl 2","key":"b5-0290008","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/j.surneu.2009.05.031","article-title":"Surgical treatment of brainstem cavernous malformations","volume":"72","author":"Garrett","year":"2009"},{"key":"b6-0290008","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"820","DOI":"10.3171\/jns.1995.83.5.0820","article-title":"The natural history of cerebral cavernous malformations","volume":"83","author":"Kondziolka","year":"1995"},{"key":"b7-0290008","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"924","DOI":"10.3171\/jns.2003.99.5.0924","article-title":"Modifications to the orbitozygomatic approach. 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