Crossed brainstem syndrome of the tectal plate's inferior colliculus revealing quadrigeminal midbrain cavernous malformation.

Autor: Beucler N; Neurosurgery department, Sainte-Anne Military Teaching Hospital, 2 boulevard Sainte-Anne, 83800 Toulon Cedex 9, France. Electronic address: nathan.beucler@neurochirurgie.fr.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Nov 20. Date of Electronic Publication: 2024 Nov 20.
DOI: 10.1016/j.wneu.2024.11.049
Abstrakt: Cavernous malformations are low-flow fragile vascular lesion, prone to extralesional bleeding that can occur in the cerebral hemispheres, the brainstem, or the spinal cord. We report the case of a 32-years-old right-handed male patient with acute-onset headaches associated with right-sided tinnitus, right-sided hemianesthesia, and binocular diplopia related to cranial nerve IV palsy. Neuroimaging displayed left-sided isolated cavernous malformation of the inferior tectal plate, with evidence of extralesional bleeding. Clinical presentation and neuroimaging features were compatible with inferior colliculus crossed brainstem syndrome. Thanks to clinical improvement and the absence of mass effect on neuroimaging, surgical intervention was delayed. At the 3 months follow-up consultation, symptoms had improved aside from diplopia which required wearing prism eyeglasses. Tectal cavernous malformations account for 18% of midbrain cavernomas. It was explained that surgical excision using the supracerebellar infratentorial approach would be performed within 2 months following a second extralesional bleeding episode causing disabling symptoms.
(Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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