The Posterior Median Sulcus Approach to a Cavernoma of the Medullar Oblongata: A Step-by-Step Video Guide

Vásquez M.; Saavedra L.J.; Apaza A.; Caucha Y.; Lozano M.; Vela Rojas E.J.; Vargas J.; Cuya D.; Heredia D.S.; Lines-Aguilar W.W. · World Neurosurgery (2025) · DOI: 10.1016/j.wneu.2025.123839

Resumen

Objective: Cavernous malformations of the brainstem often cause severe morbidity and mortality. The literature is limited regarding the optimal surgical approach.1-3 Our objective is to demonstrate successful use of the posterior median sulcus to access cavernous malformations of the brainstem. Methods: We present the case of a 20-year-old woman with an exophytic cavernous malformation of the brainstem4,5 showing signs of acute bleeding. The lesion, located near the ventricle surface, was successfully excised with entry through the posterior median sulcus. Results: The patient sustained a mild postoperative weakness but no bulbar symptoms. Complete resection was confirmed on magnetic resonance imaging. Conclusions: The posterior median sulcus is a safe route for exophytic lesions of the medulla.