{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:57Z","timestamp":1787028657407,"version":"build-2736575974"},"reference-count":50,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T00:00:00Z","timestamp":1743206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy Carol Davila"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Pontine cavernomas are rare and challenging vascular malformations, representing a critical subset of brainstem lesions due to their deep location and proximity to essential neural structures. When hemorrhagic, these lesions can cause rapid neurological deterioration, posing life-threatening risks. Management requires a delicate balance between aggressive intervention and preserving vital functions. This case report presents the successful surgical treatment of a giant hemorrhagic pontine cavernoma, highlighting the integration of advanced imaging, precision surgical techniques, and multidisciplinary care to achieve an exceptional patient outcome. Methods: A 47-year-old female presented with acute neurological deterioration, including severe right-sided hemiparesis, dysphagia, and obnubilation. High-resolution MRI, including susceptibility-weighted imaging, confirmed a giant hemorrhagic pontine cavernoma causing brainstem compression. An urgent left-sided pterional craniotomy with a transsylvian approach was performed to access the lesion. Subtotal resection and hematoma evacuation were carried out to relieve brainstem compression while preserving critical structures. Postoperative recovery and lesion stability were evaluated through clinical assessments and imaging after three months. Results: Postoperatively, the patient exhibited marked neurological recovery, with near-complete resolution of hemiparesis, restored swallowing function, and significant functional improvement. Follow-up imaging confirmed a stable residual lesion, no recurrence of hemorrhage, and a well-preserved ventricular system. The combination of early intervention and tailored surgical strategies resulted in a highly favorable outcome. Conclusions: This case underscores the complexity of managing giant hemorrhagic pontine cavernomas and demonstrates that carefully planned surgical intervention, combined with advanced imaging and patient-focused care, can yield remarkable outcomes. It highlights the critical importance of early diagnosis, meticulous surgical planning, and future innovations in neurovascular surgery to improve outcomes in these rare but high-stakes cases.<\/jats:p>","DOI":"10.3390\/jcm14072358","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T02:50:16Z","timestamp":1743389416000},"page":"2358","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Large Pontine Cavernoma with Hemorrhage: Case Report on Surgical Approach and Recovery"],"prefix":"10.3390","volume":"14","author":[{"given":"Corneliu","family":"Toader","sequence":"first","affiliation":[{"name":"Department of Neurosurgery \u201cCarol Davila\u201d, University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matei","family":"Serban","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery \u201cCarol Davila\u201d, University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania"},{"name":"Puls Med Association, 051885 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucian","family":"Eva","sequence":"additional","affiliation":[{"name":"\u201cNicolae Oblu\u201d Clinical Hospital, 700309 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Costea","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razvan-Adrian","family":"Covache-Busuioc","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery \u201cCarol Davila\u201d, University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania"},{"name":"Puls Med Association, 051885 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mugurel Petrinel","family":"Radoi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery \u201cCarol Davila\u201d, University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru Vlad","family":"Ciurea","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery \u201cCarol Davila\u201d, University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Neurosurgery Department, Sanador Clinical Hospital, 010991 Bucharest, Romania"},{"name":"Medical Section, Romanian Academy, 010071 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3784-7355","authenticated-orcid":false,"given":"Adrian Vasile","family":"Dumitru","sequence":"additional","affiliation":[{"name":"Department of Pathology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Pathology, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"CASE24314","DOI":"10.3171\/CASE24314","article-title":"Complete removal of a cavernous malformation in the dorsal pons, in contact with the expanded transpontine vein: Illustrative case","volume":"8","author":"Yamamoto","year":"2024","journal-title":"J. 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