Cavernous Malformations: Management of Difficult Pediatric and Adult Lesions-Gary K. Steinberg, MD, PhD, FAANS Video

Video Transcription

Video Summary

In this video, Dr. Gary Steinberg of Stanford University discusses the microsurgical management of brainstem, thalamic, and basal ganglia cavernous malformations. He describes the challenges and unique problems posed by these deep structures due to their sensitive nature and small size. He explains that the natural history of deep cavernous malformations is worse than supratentorial cavernous malformations, with a higher annual re-bleed rate. He discusses the limitations of stereotactic radiosurgery in treating these malformations, citing poor results and high complication rates.<br /><br />Dr. Steinberg shares his experience with surgical resection of these malformations and presents case studies to illustrate different surgical approaches in various locations, such as brainstem, thalamus, and basal ganglia. He emphasizes the importance of electrophysiological monitoring, navigation, and using techniques like the CO2 laser for resection. He also discusses the potential complications and postoperative outcomes, noting that the majority of patients experience improvement or remain stable in the long term.<br /><br />He concludes by highlighting the predictors of a good outcome, including age, preoperative neurological status, and early surgery. Dr. Steinberg expresses his gratitude to his team and encourages everyone to stay safe during the COVID-19 pandemic.<br /><br />Overall, the video serves as a comprehensive overview of the surgical management of deep cavernous malformations, sharing valuable insights from Dr. Steinberg's experience and research.

Keywords

microsurgical management

brainstem

thalamic

basal ganglia

cavernous malformations

surgical resection

electrophysiological monitoring