Table 1 clinical cases of fully endoscopic approach for resection of brainstem cavernous malformations
Study | Gender | Age | Lesion location | Lesion size | Symptom | Navigation | Surgery approach | Postoperative MRI | CSF drainage | CSF Rhinorrhea | Re-intervention | Complication | Prognosis | Follow-up |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Kimball et al., 2012 | female | 59 | the ventral midpons eccentric to the righ | 2.3 × 2.2 × 2.5 cm | bilateral facial numbness, diplopia, and complete left hemiplegia | Yes | endoscopic endonasa transclival | total | No | Yes | Yes | a right cranial nerve VI and peripheral cranial nerve VII palsy and left-sided hemiplegia | improve | 1 month |
Sanborn et al., 2012 | male | 17 | ventromedial pons, eccentric to the right side | 1.7 × 1.2 cm | a left-side hemiparesis, a right sixth nerve palsy, and dysphagia | Yes | endoscopic endonasa transclival | total | Yes | Yes | Yes | left-side hemiparesis, vertical nystagmus, right-side facial weakness, and bilaterally restricted horizontal eye movements on both left and right gaze | improve | 6 months |
Enseñat et al., 2015 | male | NA | a ventral midline mesencephalon | NA | third cranial nerve palsy | No | endosendoscopic transnasal transtuberculum-transplanum approach | subtotal | No | No | No | None | improve | NA |
Nayak, et al., 2015 | female | 39 | the left dorsal midbrain | 1.8 × 1.3 cm | headache, double vision, and rightsided numbness | No | endoscopic retrosigmoid craniotomy | total | No | No | No | None | improve | 12 months |
female | 59 | the left dorsal pons | 1.8 × 1.4 cm | left ear hearing loss and facial paresis | No | endoscopic retrosigmoid craniotomy | subtotal | No | No | No | facial paralysis(6/6) | same | 18 months | |
female | 60 | the ventromedial cervicomedullary junction | 0.8 × 0. 9 × 1 cm | right hemiparesis | Yes | endoscopic endonasa transclival | total | No | No | No | None | same | 3 months | |
male | 17 | in the ventromedial pons | 2.1 × 1.7 cm | headache and rightsided facial numbness | Yes | endoscopic endonasa transclival | total | No | Yes | Yes | left hemiparesis and rightsided, vertical nystagmus and restricted horizontal gaze bilaterally facial weakness | improve | 24 months | |
Linsler et al., 2015 | female | 29 | the ventral pons | 2.0 × 1.8 × 2.2 cm | Numbness and tingling of right arm and leg, loss of fine motor control of right hand, transient diplopia, transient headache | Yes | endoscopic endonasa transclival | total | Yes | No | No | None | improve | 6 weeks |
Dallan et al., 2015 | male | 15 | ventromedial pons, eccentric to the right side | 1.0 × 1.0 cm | severe cephalalgia with vomiting and neurological signs including diplopia, sudden hearing loss and facial palsy | Yes | endoscopic endonasa transclival | subtotal | No | No | No | None | improve | 24 months |
Shi-Ming He et al., 2016 | female | 20 | the right ventromedial mesencephalon | 1.2 × 1.7 cm | left-sided hemiparesis, restriction of medial and lateral left-eye movements, and loss of left pupillary light reflex | Yes | endoscopic endonasa transclival | total | Yes | No | No | None | improve | 3 months |
Gómez-Amador JL et al., 2017 | male | 29 | ventral pons | 1.8 × 2.6 × 2.9 cm | Acute occipital headache, nausea, horizontal diplopia. Somnolence, facial palsy, dysarthria, dysphonia, dysphagia, left hemiparesis | Yes | endoscopic endonasa transclival | total | No | No | No | None | improve | 5 months |
Puya Alikhani et al., 2019 | female | 26 | left medulla oblongata | 1.5 cm | imbalance, swallowing difficulty, and right hemibody weakness | Yes | endoscopic endonasa transclival | total | No | No | No | None | improve | 3 months |
Xiao Dong et al., 2021 | female | 28 | a ventral pontine lesion eccentric to the left | 2.3 × 2.0 cm | right-sided hemiparesis, diplopia and hemiparethesia | Yes | endoscopic endonasa transclival | total | Yes | No | No | None | improve | 1 month |
Lima et al., 2019 | female | 46 | pons | 2.6 cm | mild right hemiparesis | No | endoscopic endonasa transclival | total | No | Yes | Yes | a slight worsening of right hemiparesis | improve | 6 months |
Cecchini, 2019 | female | 40 | the junction between posterior mesencephalon and upper pons | NA | None | Yes | endoscopic subtemporal approach | total | Yes | No | No | None | same | NA |
Goldschmidt et al., 2019 | female | 25 | midbrain | NA | diplopia and headache | Yes | endoscopic endonasa transclival | total | Yes | No | No | None | improve | 1 month |
Paolo Priore et al., 2022 | female | 14 | ventral pons | NA | a state of coma | Yes | endoscopic endonasa transclival | subtotal | No | No | No | None | improve | 96 months |
Takeuchi K et al., 2023 | female | 64 | ventral pons | 2.3 × 2.3 × 2.5 cm | Lt hemiparesis 2/5, CN VI palsy, mRS 4 | NA | endoscopic endonasa transclival | total | No | No | No | None | improve | 3 months |
female | 44 | ventral pons | 3.5 × 3.4 × 3.8 cm | Lt hemiparesis 2/5, mRS 4 | NA | endoscopic endonasa transclival | total | No | No | No | None | improve | 3 months | |
female | 33 | ventral pons | 1.6 × 1.2 × 1.8 cm | Lt hemiparesis 4/5, CN VI palsy, mRS 3 | NA | endoscopic endonasa transclival | total | No | Yes | Yes | None | improve | 3 months | |
female | 49 | ventral pons | 1.6 × 1.6 × 2.5 cm | Lt hemiparesis 4/5, CN VI palsy, mRS 3 | NA | endoscopic endonasa transclival | total | No | No | No | Transient worsening of CN VI palsy | improve | 3 months | |
male | 46 | ventral pons | 2.0 × 2.4 × 2.0 cm | Rt hemiparesis 4/5, mRS 3 | NA | endoscopic endonasa transclival | total | No | No | No | None | improve | 3 months | |
NA: No data; CSF: Cerebrospinal fluid; LT: left; Rt: right; mRS: modified Rankin Scale | ||||||||||||||