Medulla Oblongata Cavernoma Removal Through a Lazy Far Lateral Approach: Operative Video and Technical Nuances

Carlos Candanedo, MD, Samuel Moscovici, MD, and Sergey Spektor, MD, PhD
Department of Neurosurgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel

Removal of brainstem cavernous malformation remains a surgical challenge. We present a case of a 63-year-old female who was diagnosed with a large cavernoma located in the medulla oblongata. The patient suffered three episodes of brainstem bleeding resulting in significant neurological deficits (hemiparesis, dysphagia, and dysarthria). It was decided to remove the cavernoma through a left-sided modified far lateral approach.

The operative video demonstrates the surgical steps and nuances of a complete removal of this complex medulla oblongata cavernous malformation. Total resection was achieved without complications. Postoperative MRI revealed no signs of residual cavernoma with clinical improvement.

The video can be found here: https://youtu.be/BTtMvvLMOFM.

KEYWORDS: brainstem; cavernoma; far lateral approach; medulla; video