Microsurgical laser resection of brainstem cavernous malformations
Ephraim W. Church, MD, and Gary K. Steinberg, MD, PhD Department of Neurosurgery and Stanford Stroke Center, Stanford University School of Medicine, Stanford, California This operative technique video demonstrates laser microsurgery for brainstem cavernous malformations (CMs). In case 1 we demonstrate CO2 laser microsurgery for a symptomatic pontine CM using far lateral craniotomy and olivary zone entry. Case 2 demonstrates the subtemporal approach and removal of a paratrigeminal CM, and case 3 is a dorsal midbrain CM. We illustrate several advantages of laser microsurgery including improved visualization in narrow corridors, precise cutting with reduced thermal damage, and effective sealing of small vessels. Over the past decade at Stanford University School of Medicine, over 120 brainstem CMs have been removed using laser microsurgery with good results. **Intro music: "Daybreak" by Graeme Rosner