Brainstem cavernous XXXX .

@entity1 @entity548 @entity146 @entity600 @entity51 @entity1462
Of all cavernous @entity600 (CMs), 4% to 35% are found in the brainstem accounting for 13% of @entity1462 of the posterior fossa. The annual risk of @entity548 associated with a CM with no history of a previous @entity548 is very low ranging from 0.6% to 1.1% per year. However, the risk of recurrent @entity548 after a presenting bleed is significantly higher. There is a correlation between the extent of persistent @entity51 and the number of recurrent @entity548 as rehemorrhage increases the rate and severity of @entity51 . @entity51 often improve after a hemorrhagic event spontaneously and sometimes resolve completely. The indication for surgery in @entity1 with brainstem CMs is controversial. Over the years, we have taken a more cautious stance and we often recommend observation in @entity1 after a single symptomatic bleed as most @entity1 return to a good level of functioning after a single bleed. Surgery is recommended for more @entity146 lesions usually after a recurrent bleed. In general, given the very low risk of bleeding from truly asymptomatic lesions, surgery should not be considered in these @entity1 . For symptomatic lesions which have presented with @entity548 , the decision of whether or not to proceed with surgical resection is related to the risk of surgery, @entity1 's disposition and perceived risk of rebleeding. Favorable outcome can be achieved through surgical resection after an appropriate selection of the @entity1 and thorough preoperative surgical planning.
