Stereotactic Radiosurgery Versus Microsurgery for Brainstem Cavernous Malformations

Lee, Byung-Joo; Choi, Chan-Young; Lee, Dong-Joon; Han, Seong-Rok; Sohn, Moon-Jun; Lee, Chae-Heuck

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2013;9(1):6-10.
Published online June 30, 2013.

Stereotactic Radiosurgery Versus Microsurgery for Brainstem Cavernous Malformations

Byung-Joo Lee, Chan-Young Choi, Dong-Joon Lee, Seong-Rok Han, Moon-Jun Sohn, Chae-Heuck Lee

Department of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea

Abstract

Purpose
We performed a retrospective review to evaluate the effectiveness of stereotactic radiosurgery and microsurgery for brainstem cavernous malformations.
Methods
Between 2000 and 2011, 13 patients with brainstem cavernous malformations who underwent stereotactic radiosurgery or/and microsurgery were enrolled in this study. We analyzed the clinical data including clinical symptoms, location, size, neurological status, extent of resection, radiation doses, and complications.
Results
In microsurgery, gross total resection without further neurological deteriorations was performed in 75% and neurological improvements were achieved in 67%. In stereotactic radiosurgery, volume reduction and clinical improvements were achieved in 75% respectively without any adverse radiation effects. Rebleedings following radiosurgery were found in 2 cases and one of them led to subsequent microsurgery.
Conclusion
Surgical resection is the primary therapeutic option for symptomatic brainstem cavernous malformations. However, stereotactic radiosurgery may be a non-invasive, effective alternative for surgically inaccessible lesions.

Key Words: Cavernous malformation, Brainstem, Microsurgery, Radiosurgery.