{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T01:24:45Z","timestamp":1769304285722,"version":"3.49.0"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1991,7]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Once they become symptomatic, cavernous malformations of the brain stem appear to cause progressive morbidity from repetitive hemorrhage, and can even be fatal. Twenty-four patients with long-tract and\/or\ncranial nerve findings from their cavernous malformations of the brain stem were seen for initial evaluation or surgical consultation and thereafter received either surgical or continued conservative treatment. The decision to operate was based on the proximity of the cavernous malformation to the pial surface of the brain stem, the patient's neurological status, and the number of symptomatic episodes. Sixteen patients were treated by definitive surgery directed at excision of their malformation. In four patients, associated venous malformations influenced the surgical approach and their recognition avoided the risk of inappropriate excision of the venous malformation. Although some of the 16 patients had transient, immediate, postoperative worsening of their neurological deficits, the outcome of all except one was the same or improved. Only one patient developed recurrent symptoms: a new deficit 2\u00bd years after surgery required reoperation after regrowth of the cavernous malformation. She has been neurologically stable since the second surgery. One patient died 6 months postoperatively from a shunt infection and sepsis. The eight conservatively treated patients are followed with annual magnetic resonance imaging studies. One has a dramatic associated venous malformation. Seven patients have either minor intermittent or no symptoms, and the eighth died from a hemorrhage 1 year after his initial presentation.<\/jats:p>\n<jats:p content-type=\"fine-print\">Based on these results, surgical extirpation of symptomatic cavernous malformations of the brain stem appears to be the treatment of choice when a patient is symptomatic, the lesion is located superficially, and an operative approach can spare eloquent tissue. When cavernous malformations of the brain stem are completely excised, cure appears permanent.<\/jats:p>","DOI":"10.3171\/jns.1991.75.1.0032","type":"journal-article","created":{"date-parts":[[2009,5,19]],"date-time":"2009-05-19T16:22:46Z","timestamp":1242750166000},"page":"32-39","source":"Crossref","is-referenced-by-count":203,"title":["Cavernous malformations of the brain stem"],"prefix":"10.3171","volume":"75","author":[{"given":"Richard S.","family":"Zimmerman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert F.","family":"Spetzler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. Stuart","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph M.","family":"Zabramski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald W.","family":"Hargraves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neurosurgery","first-page":"102","article-title":"Familial cavernous angioma of the brain stem dominantly inherited in Hispanics.","volume":"24","author":"Bicknell","year":"1989"},{"key":"b2","series-title":"J Neurosurg","first-page":"698","article-title":"Stereotactic resection of occult vascular malformations.","volume":"72","author":"Davis","year":"1990"},{"key":"b3","series-title":"Acta Neurochir","first-page":"61","article-title":"Cavernous angiomas of the brain. Account of fourteen personal cases and review of the literature.","volume":"40","author":"Giombini","year":"1978"},{"key":"b4","series-title":"J Neurosurg","first-page":"27","article-title":"Diagnosis and treatment of vascular brain-stem malformations.","volume":"72","author":"Kashiwagi","year":"1990"},{"key":"b5","series-title":"Neurosurgery","first-page":"990","article-title":"Comment on Seifert V, Gaab MR: Laser-assisted microsurgical extirpation of the brain stem cavernoma: case report.","volume":"25","author":"Kelly","year":"1989"},{"key":"b6","series-title":"Surg Neurol","first-page":"350","article-title":"Venous angiomas: an underestimated cause of intracranial hemorrhage.","volume":"30","author":"Malik","year":"1988"},{"key":"b7","series-title":"Neurology","first-page":"324","article-title":"Familial cavernous angiomas of the brain in an Hispanic family.","volume":"38","author":"Mason","year":"1988"},{"key":"b8","series-title":"J Neurosurg","first-page":"807","article-title":"The pathology of vascular (\u201carteriovenous\u201d) malformations.","volume":"24","author":"McCormick","year":"1966"},{"key":"b9","series-title":"Intracranial Arteriovenous Malformations.","first-page":"44","article-title":"Pathology of vascular malformations of the brain","author":"McCormick","year":"1984"},{"key":"b10","series-title":"J Neurosurg","first-page":"350","article-title":"Angiographically occult arteriovenous malformations.","volume":"69","author":"Ogilvy","year":"1988"},{"key":"b11","series-title":"J Neurosurg","first-page":"518","article-title":"The MRI appearance of cavernous malformations (angiomas).","volume":"67","author":"Rigamonti","year":"1987"},{"key":"b12","series-title":"N Engl J Med","first-page":"343","article-title":"Cerebral cavernous malformations. Incidence and familial occurrence.","volume":"319","author":"Rigamonti","year":"1988"},{"key":"b13","series-title":"Acta Neurochir","first-page":"100","article-title":"The association of venous and cavernous malformations. Report of four cases and discussion of the pathophysiological, diagnostic, and therapeutic implications.","volume":"92","author":"Rigamonti","year":"1988"},{"key":"b14","series-title":"J Neurosurg","first-page":"560","article-title":"Cerebral venous malformations.","volume":"73","author":"Rigamonti","year":"1990"},{"key":"b15","series-title":"J Neurosurg","first-page":"333A","article-title":"The natural history of cavernous angiomas.","volume":"72","author":"Robinson","year":"1990"},{"key":"b16","series-title":"J Neurosurg","first-page":"647","article-title":"Thalamic cavernous malformation. Case report.","volume":"72","author":"Roda","year":"1990"},{"key":"b17","series-title":"Pathology of Tumours of the Nervous System","author":"Russell","year":"1977"},{"key":"b18","series-title":"Surg Neurol","first-page":"467","article-title":"Familial cavernous malformations. Diagnostic potential of magnetic resonance imaging.","volume":"29","author":"Rutka","year":"1988"},{"key":"b19","series-title":"Neurosurgery","first-page":"162","article-title":"Cavernous angioma: a review of 126 collected and 12 new clinical cases.","volume":"18","author":"Simard","year":"1986"},{"key":"b20","series-title":"J Neurosurg","first-page":"642","article-title":"Angiographically occult intracranial vascular malformations.","volume":"69","author":"Spetzler","year":"1988"},{"key":"b21","series-title":"Surg Neurol","first-page":"412","article-title":"Letter to the Editor.","volume":"31","author":"Spetzler","year":"1989"},{"key":"b22","series-title":"Pathology of the Cerebral Blood Vessels.","first-page":"471","author":"Stehbens","year":"1972"},{"key":"b23","series-title":"Acta Neurochir","first-page":"29","article-title":"Cavernomas of the central nervous system: clinical syndromes, CT scan diagnosis, and prognosis after surgical treatment in 25 cases.","volume":"85","author":"Vaquero","year":"1987"},{"key":"b24","series-title":"Neurochirurgia","first-page":"59","article-title":"Cerebral cavernous haemangiomas or cavernomas. Incidence, pathology, localization, diagnosis clinical features and treatment. Review of the literature and report of an unusual case.","volume":"19","author":"Voigt","year":"1976"},{"key":"b25","series-title":"Microsurgery. IIIB. AVM of the Brain, Clinical Considerations, General and Special Operative Techniques, Surgical Results, Nonoperated Cases, Cavernous and Venous Angiomas, Neuroanesthesia.","first-page":"405","author":"Ya\u015fargil","year":"1988"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/75\/1\/article-p32.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/75\/1\/article-p32.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/75\/1\/article-p32.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T21:54:14Z","timestamp":1679262854000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/75\/1\/article-p32.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1991,7]]},"references-count":25,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/jns.1991.75.1.0032","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1991,7]]}}}