Microsurgery For Brainstem Vascular Malformation (the Report Of 19 Cases)

Object: To study the microsurical management of brainstem vascular malformation and share in our experience.Methods: In this article, we retrospected and followed up 19 cases of brainstem vascular malformations from March in 2000 to March in 2010 in China-Japan union hospital of JiLin university,which were treated microurgicallay including nine in the pons,nine in the borderline of pona and medulla ,one in the medulla. Six cases of cavernous malformations in the dorsal of pons and medulla underwent operations via through the base of the fourth ventricle approach,nine cases of cavernous malformations in the lateral of pons wered treated via suboccipito-retrosigmoid approach,three cases of AVM in the borderline of pona and medulla wered treated via telovelar approaches. One cases of AVM in the dorsal of medulla wered treated via transvermian approach.Results:All of the lesions were totally resected. Pathologic diagnosis 15 cases was cavernous malformations, and the others was AVM. Among 19 cases in disch, 17(89.4%) got eusemia, The functional disorders were improved after operation in these cases. 2(10.5%) got syndromes appeared .One case died because of infection of lung after operation. During two months to six year after operation the brainstem vascular malformations didn't recrudesce and rehaemorrhagia, the patients hadn't appear the new syndromes.Conclusion: The microsurical management of brainstem vascular malformation can effectively prevent re-bleeding.To select different surgical approach for different locations of brainstem vascular malformation can reduce the nerve damage. To accelerate the recovery of damaged brainstem, early surgery should be choose for Surgical indications exist in patients.the telovelar approach provides greater area of exposure than the transvermian approach and was injuried in vermis of Cerebellar.patient management is one of the most important infludencing factors of brain stem vascular malformation in peroperative period. If we choice surgical indications Correctly, proficient in microanatomy using extensive knowledge minimally ,Concept of minimally invasive surgery and skillful microsurgical technique, the surgery results of brain stem vascular malformation are satisfactory.