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CONTROVERSIES IN THE MANAGEMENT OF BRAINSTEM CAVERNOUS ANGIOMA: REPORT OF TWO CASES
Lali H. S. Sekhon,
Michael K. Morgan,
Michael Besser,
Wirginia Maixner,
Lali H. S. Sekhon
*Department of Surgery, The University of Sydney, Sydney, New South Wales, Australia
Search for more papers by this authorCorresponding Author
Michael K. Morgan
*Department of Surgery, The University of Sydney, Sydney, New South Wales, Australia
Department of Surgery D06, The University of Sydney, Sydney, NSW 2006, Australia.Search for more papers by this authorMichael Besser
†Department of Neurosurgery, Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia
Search for more papers by this authorWirginia Maixner
†Department of Neurosurgery, Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia
Search for more papers by this authorLali H. S. Sekhon,
Michael K. Morgan,
Michael Besser,
Wirginia Maixner,
Lali H. S. Sekhon
*Department of Surgery, The University of Sydney, Sydney, New South Wales, Australia
Search for more papers by this authorCorresponding Author
Michael K. Morgan
*Department of Surgery, The University of Sydney, Sydney, New South Wales, Australia
Department of Surgery D06, The University of Sydney, Sydney, NSW 2006, Australia.Search for more papers by this authorMichael Besser
†Department of Neurosurgery, Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia
Search for more papers by this authorWirginia Maixner
†Department of Neurosurgery, Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia
Search for more papers by this authorAbstract
Two cases of cavernous angioma involving the medulla oblongata are presented. Both cases underwent surgical excision with excellent outcome. The use of surgery via craniectomy is contrasted with stereotactic radiosurgery in light of the known natural history of the lesions. As a result, it is suggested that surgical excision provides immediate protection from the risks of recurrent haemorrhage, establishes a tissue diagnosis, allows complete removal at the primary intervention, avoids complications of radiation-induced damage and is performed more easily in these vascular anomalies due to the presence of a capsule with surrounding gliotic tissue. Additionally, it is implied that the natural history of lesions in this region is still unclear. For these reasons, it is suggested that surgical excision should be the primary therapeutic intervention for cavernous angiomata that involve the brainstem.
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