Minimally Invasive Parafascicular Surgery for Resection of Cerebral Cavernous Malformations Utilizing Image-Guided BrainPath System.
BACKGROUND
The minimally invasive parafascicular approach provides a surgical corridor to reach deep lesions with minimal impact on the surrounding brain tissue.


OBJECTIVE
To evaluate the safety and efficacy of this approach utilizing the image-guided tubular BrainPath system (NICO Corp, Indianapolis, Indiana) for the resection of deep and subcortical supratentorial cerebral cavernous malformations (CCMs).


METHODS
We performed a retrospective analysis of patients who presented with subcortical CCMs treated with the BrainPath system. Patient demographics, clinical presentation, procedural complications, and clinical and imaging follow-up information were assessed.


RESULTS
Six patients were identified between December 2014 and November 2017 at a large volume academic institution in the United States. There were 3 males and 3 female patients with a median age of 25 yr. Locations included frontal, temporal, and parietal lobes. In selected cases, the fiber-sparing trajectory imposed a longer approach than the closest distance to the brain surface. Except for 1 patient who suffered from surgical wound dehiscence, there were no operative complications in any of the cases. All patients remained neurologically stable postoperatively with a mean follow-up of 20 moh.


CONCLUSION
This small series suggests that the use of a minimally invasive surgical approach to CCMs utilizing the image-guided parafascicular tubular BrainPath system is feasible, safe, and effective.
['Goren|Oded|O|', 'Griessenauer|Christoph J|CJ|', 'Bohan|Christian O|CO|', 'Berry|Christopher M|CM|', 'Schirmer|Clemens M|CM|']
D000328:Adult D001932:Brain Neoplasms D005260:Female D005625:Frontal Lobe D020786:Hemangioma, Cavernous, Central Nervous System D006801:Humans D008297:Male D000073216:Mental Status and Dementia Tests D008875:Middle Aged D019060:Minimally Invasive Surgical Procedures D038361:Neuronavigation D019635:Neurosurgical Procedures D010296:Parietal Lobe D017060:Patient Satisfaction D013529:Surgical Wound Dehiscence D013702:Temporal Lobe D016896:Treatment Outcome D055815:Young Adult
Minimally invasive parafascicular surgery Cerebral cavernous malformation