Abstract

Introduction: Anterior pontine cavernomais a rare pathology with difficult access; it predominantly occurs in middle-aged patients with a high risk of bleeding and rebleeding. There is a direct association with genetic inheritance due to the CCM1, CCM2 and CCM3 genes, and if it is associated, there is a higher risk of severity.

Materials and Methods:Analysis of PUBMED publications about ventral pontine cavernomas, anterolateral pontine cavernomas, and main surgical approaches.

Results and Discussion:Pontine cavernomas have a bleeding risk of 5% per year and rebleeding of 30% per year; therefore, it is a surgical pathology in which most authors approach from four to six weeks after bleeding for total resection and curative purposes. There are different approaches and they depend on the topography of the lesion and the surgeon`s ability; technologies such as monitoring, neuronavigation, and tractography must be used to reduce the risk of lesions. The most used approaches are retrosigmoid, presigmoid, and anterior transpetrosal; the use of endoscopic approaches has been increasing recently.

Conclusion: Anterior pontine cavernoma is a severe pathology that must be surgically treated to decrease the risk of bleeding and rebleeding.

Keywords

Cavernoma, Pontine cavernoma, Cavernous angioma, Pontine hemorrhage, Supratentorial cavernomas, Rebleeding, Hemorrhage, Seizure, Gaze palsy, Diplopia, Postoperative deficits, Retrosigmoid approach, Retrolabyrinthine, Trigeminal nerves, Brainstem, Tentorium