STEREOTAXIC AND ULTRASOUND-GUIDED MINIMAL INVASIVE SURGERY OF SUBCORTICAL CAVERNOMAS

The experience of 7 operated patients with cavernous haemangiomas (CHa ) and of 2 conservatively treated older patients is reported. There wa s no further postoperative neurological deficit, although 6 of the 7 p atients had the CHa in an eloquent cerebral region. Two of the operate d patients (22%) had several bleedings before surgery. In these cases seizures and visual field deficits remained. The relatively low rate o f complications in our patient,group was possible because an exact pre operative localisation helped to avoid a large traumatisation. This is possible with a stereotactic system or directly by CT guided skin mar king. Intraoperative ultrasound was necessary in all cases because the re was no landmark at the cerebral surface. The CHa was removed by a t ranssulcal microsurgical operation. A complete removal of the surround ing haemosiderin rim around the angioma seems necessary to avoid furth er seizures. The used technique has proved to be a simple and safe min imal invasive method.