Treatment strategies of medulla oblongata cavernous malformations

Objective To discuss the strategies and efficacies of surgical treatment in medulla oblongata cavernous malformations. Methods The clinical and follow-up data of 9 patients with medulla oblongata cavernous malformations, admitted to our hospital from October 2011 to February 2015, were retrospectively analyzed. Five patients underwent surgical treatment: posterior midline transcerebellomedullary fissure approach was used in 4, far-lateral transcondylar approach in one, and all cavernous malformations were excised completely. Conservative treatment and regular observation were done in 4 patients. Follow-up was performed for 10-40 months. Results Symptoms improved after surgery in 4 patients; postoperative hemiplegia appeared in one, and at the end of follow-up, the muscle strength of hemiplegic limbs recovered to level IV. Minor re-hemorrhage was noted in one of the 4 patients with conservative treatment at the end of the follow-up, and no changes were noted in the rest patients. Karnofsky Performance Scale scores were 82.2±6.7, which were significantly increased as compared with those before treatment (73.3±11.2, P<0.05). Conclusion After strict preoperative evaluation, surgical treatment is a feasible way, enjoying good prognosis in medulla oblongata cavernous malformations; but, patients with deep site, small malformations or no obvious bleeding symptoms should not be operated. Key words: Cavernous malformation; Medulla oblongata; Surgery