{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:46:48Z","timestamp":1772610408335,"version":"3.50.1"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:p>Cavernomas comprise 8%\u201315% of intracranial vascular lesions, usually supratentorial in location and superficial. Cavernomas in the thalamus or subcortical white matter represent a unique challenge for surgeons in trying to identify and then use a safe corridor to access and resect the pathology. Previous authors have described specific open microsurgical corridors based on pathology location, often with technical difficulty and morbidity. This series presents 2 cavernomas that were resected using a minimally invasive approach that is less technically demanding and has a good safety profile. The authors report 2 cases of cavernoma: one in the thalamus and brainstem with multiple hemorrhages and the other in eloquent subcortical white matter. These lesions were resected through a transulcal parafascicular approach with a port-based minimally invasive technique. In this series there was complete resection with no neurological complications. The transulcal parafascicular minimally invasive approach relies on image interpretation and trajectory planning, intraoperative navigation, cortical cannulation and subcortical space access, high-quality optics, and resection as key elements to minimize exposure and retraction and maximize tissue preservation. The authors applied this technique to 2 patients with cavernomas in eloquent locations with excellent outcomes.<\/jats:p>","DOI":"10.3171\/2015.12.jns152185","type":"journal-article","created":{"date-parts":[[2016,3,4]],"date-time":"2016-03-04T14:58:28Z","timestamp":1457103508000},"page":"1360-1366","source":"Crossref","is-referenced-by-count":20,"title":["Transulcal parafascicular minimally invasive approach to deep and subcortical cavernomas: technical note"],"prefix":"10.3171","volume":"125","author":[{"given":"Robert A.","family":"Scranton","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve H.","family":"Fung","sequence":"additional","affiliation":[{"name":"Radiology, Houston Methodist Neurological Institute, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin W.","family":"Britz","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1227\/00006123-199308000-00001","article-title":"Mixed vascular malformations of the brain: clinical and pathogenetic considerations","volume":"33","author":"Awad","year":"1993"},{"key":"b2-jns152185","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.1007\/s00701-004-0367-4","article-title":"Stereotactically guided microsurgical removal of colloid cysts","volume":"146","author":"Barlas","year":"2004"},{"key":"b3-jns152185","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s101430100179","article-title":"Cerebral cavernomas in the adult. Review of the literature and analysis of 72 surgically treated patients","volume":"25","author":"Bertalanffy","year":"2002"},{"key":"b4-jns152185","series-title":"AJNR Am J Neuroradiol","first-page":"987","article-title":"Cerebral developmental venous anomalies associated with head and neck venous malformations","volume":"17","author":"Boukobza","year":"1996"},{"key":"b5-jns152185","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"814","DOI":"10.3171\/2010.5.JNS091159","article-title":"Supratentorial cavernous malformations in eloquent and deep locations: surgical approaches and outcomes. Clinical article","volume":"114","author":"Chang","year":"2011"},{"issue":"1 Suppl 1","key":"b6-jns152185","series-title":"Neurosurgery","first-page":"ONS41","article-title":"Posterior interhemispheric approach: surgical technique, application to vascular lesions, and benefits of gravity retraction","volume":"59","author":"Chi","year":"2006"},{"key":"b7-jns152185","series-title":"Practical Surgical Neuropathology: A Diagnostic Approach","article-title":"Vascular and ischemic disorders","author":"Decker","year":"2010"},{"key":"b8-jns152185","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"160","DOI":"10.3171\/jns.1999.90.1.0160","article-title":"Accuracy of true frameless stereotaxy: in vivo measurement and laboratory phantom studies. Technical note","volume":"90","author":"Dorward","year":"1999"},{"key":"b9-jns152185","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"990","DOI":"10.3171\/2009.10.JNS09933","article-title":"High-definition fiber tracking guidance for intraparenchymal endoscopic port surgery","volume":"113","author":"Fernandez-Miranda","year":"2010"},{"key":"b10-jns152185","series-title":"J Neurointerv Surg","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1136\/neurintsurg-2014-011358","article-title":"Minimally invasive evacuation of parenchymal and ventricular hemorrhage using the Apollo system with simultaneous neuronavigation, neuroendoscopy and active monitoring with cone beam CT","volume":"7","author":"Fiorella","year":"2015"},{"key":"b11-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1227\/01.NEU.0000347009.32480.D8","article-title":"Cavernous malformations of the basal ganglia and thalamus","volume":"65","author":"Gross","year":"2009"},{"issue":"Suppl 2","key":"b12-jns152185","series-title":"Neurosurgery","first-page":"622","article-title":"Microsurgical removal of intraventricular lesions using endoscopic visualization and stereotactic guidance","volume":"62","author":"Harris","year":"2008"},{"key":"b13-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1097\/00006123-199809000-00066","article-title":"Measurement of intraoperative brain surface deformation under a craniotomy","volume":"43","author":"Hill","year":"1998"},{"key":"b14-jns152185","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"116","DOI":"10.3171\/2008.7.JNS08226","article-title":"Completely endoscopic resection of intraparenchymal brain tumors","volume":"110","author":"Kassam","year":"2009"},{"key":"b15-jns152185","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"301","DOI":"10.3171\/jns.1988.69.2.0301","article-title":"The stereotaxic retractor in computer-assisted stereotaxic microsurgery. Technical note","volume":"69","author":"Kelly","year":"1988"},{"key":"b16-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1097\/00006123-200005000-00032","article-title":"Expression of structural proteins and angiogenic factors in cerebrovascular anomalies","volume":"46","author":"Kili\u00e7","year":"2000"},{"key":"b17-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1097\/00006123-199905000-00090","article-title":"Endoscopic resection of colloid cysts: surgical considerations using the rigid endoscope","volume":"44","author":"King","year":"1999"},{"issue":"4","key":"b18-jns152185","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E9","DOI":"10.3171\/2011.2.FOCUS10313","article-title":"Early endoscope-assisted hematoma evacuation in patients with supratentorial intracerebral hemorrhage: case selection, surgical technique, and long-term results","volume":"30","author":"Kuo","year":"2011"},{"key":"b19-jns152185","series-title":"Oper Tech Neurosurg","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1053\/otns.2002.32493","article-title":"Contralateral interhemispheric resection of thalamic cavernous malformations with frameless stereotaxy","volume":"5","author":"Lanzino","year":"2002"},{"key":"b20-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1097\/00006123-199610000-00016","article-title":"The contralateral transcallosal approach: experience with 32 patients","volume":"39","author":"Lawton","year":"1996"},{"key":"b21-jns152185","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1016\/j.wneu.2012.01.037","article-title":"Surgical treatment and long-term outcomes of thalamic cavernous malformations","volume":"79","author":"Li","year":"2013"},{"issue":"2 Suppl","key":"b22-jns152185","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"S18.e1","DOI":"10.1016\/j.wneu.2012.02.022","article-title":"Endoneurosurgical resection of intraventricular and intraparenchymal lesions using the port technique","volume":"79","author":"McLaughlin","year":"2013"},{"key":"b23-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1227\/00006123-199306000-00006","article-title":"Resection of intraventricular tumorsvia a computer-assisted volumetric stereotactic approach","volume":"32","author":"Morita","year":"1993"},{"key":"b24-jns152185","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.3171\/jns.2000.92.6.1053","article-title":"A transparent sheath for endoscopic surgery and its application in surgical evacuation of spontaneous intracerebral hematomas. Technical note","volume":"92","author":"Nishihara","year":"2000"},{"key":"b25-jns152185","series-title":"J Neurol Surg A Cent Eur Neurosurg","first-page":"195","article-title":"Outcomes after endoscopic port surgery for spontaneous intracerebral hematomas","volume":"75","author":"Ochalski","year":"2014"},{"key":"b26-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.1227\/NEU.0b013e31820b4f6a","article-title":"Endoscopic port surgery for resection of lesions of the cerebellar peduncles: technical note","volume":"68","author":"Ochalski","year":"2011"},{"key":"b27-jns152185","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1007\/s00701-006-0768-7","article-title":"New microsurgical technique for intraparenchymal lesions of the brain: transcylinder approach","volume":"148","author":"Ogura","year":"2006"},{"key":"b28-jns152185","series-title":"Acta Neurochir Suppl","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/978-3-211-76589-0_7","article-title":"Thalamic cavernous angioma: paraculminar supracerebellar infratentorial transtentorial approach for the safe and complete surgical removal","volume":"103","author":"Otani","year":"2008"},{"key":"b29-jns152185","series-title":"Schmidek & Sweet Operative Neurosurgical Techniques","first-page":"977","article-title":"Surgical management of cavernous malformations of the nervous system","author":"Patel","year":"2012"},{"key":"b30-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1227\/00006123-199604000-00006","article-title":"Growth, subsequent bleeding, and de novo appearance of cerebral cavernous angiomas","volume":"38","author":"Pozzati","year":"1996"},{"key":"b31-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1227\/00006123-198907000-00017","article-title":"The growth of cerebral cavernous angiomas","volume":"25","author":"Pozzati","year":"1989"},{"key":"b32-jns152185","series-title":"Case Rep Neurol Med","first-page":"102307","article-title":"Minimally invasive subcortical parafascicular transsulcal access for clot evacuation (Mi SPACE) for intracerebral hemorrhage","volume":"2014","author":"Ritsma","year":"2014"},{"key":"b33-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1097\/00006123-199810000-00010","article-title":"Intraoperative brain shift and deformation: a quantitative analysis of cortical displacement in 28 cases","volume":"43","author":"Roberts","year":"1998"},{"key":"b34-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1097\/00006123-199605000-00011","article-title":"Expression of angiogenic factors and structural proteins in central nervous system vascular malformations","volume":"38","author":"Rothbart","year":"1996"},{"key":"b35-jns152185","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"38","DOI":"10.3171\/jns.1992.76.1.0038","article-title":"Cavernous angiomas of the central nervous system in children","volume":"76","author":"Scott","year":"1992"},{"key":"b36-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1227\/00006123-198602000-00008","article-title":"Cavernous angioma: a review of 126 collected and 12 new clinical cases","volume":"18","author":"Simard","year":"1986"},{"key":"b37-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1227\/00006123-198712000-00016","article-title":"Clinicopathological relations of cerebral cavernous angiomas: observations in eleven cases","volume":"21","author":"Steiger","year":"1987"},{"key":"b38-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1097\/00006123-200002000-00003","article-title":"Microsurgical resection of brainstem, thalamic, and basal ganglia angiographically occult vascular malformations","volume":"46","author":"Steinberg","year":"2000"},{"issue":"Suppl 2","key":"b39-jns152185","series-title":"Neurosurgery","first-page":"43","article-title":"Novel device and technique for minimally invasive intracerebral hematoma evacuation in the same setting of a ruptured intracranial aneurysm: combined treatment in the neurointerventional angiography suite","volume":"11","author":"Turner","year":"2015"},{"key":"b40-jns152185","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.3171\/2009.4.JNS081506","article-title":"A new expandable cannula system for endoscopic evacuation of intraparenchymal hemorrhages","volume":"111","author":"Waran","year":"2009"},{"key":"b41-jns152185","series-title":"AJNR Am J Neuroradiol","first-page":"1247","article-title":"Simultaneous occurrence of developmental venous anomalies and cavernous angiomas","volume":"15","author":"Wilms","year":"1994"},{"key":"b42-jns152185","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1227\/NEU.0000000000000339","article-title":"Contralateral interhemispheric approach to deep-seated cavernous malformations: surgical considerations and clinical outcomes in 31 consecutive cases","volume":"75","author":"Zaidi","year":"2014"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/125\/6\/article-p1360.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/125\/6\/article-p1360.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/125\/6\/article-p1360.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T23:47:45Z","timestamp":1682812065000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/125\/6\/article-p1360.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12]]},"references-count":42,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2015.12.jns152185","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,12]]}}}