gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

Posterior fossa cavernous malformations: A surgical series of 35 patients

Kavernöse Malformationen der hinteren Schädelgrube: Eine Serie von 35 operierten Patienten

Meeting Abstract

  • corresponding author I.E. Sandalcioglu - Klinik für Neurochirurgie, Universitätsklinikum Essen
  • B. El-Hamalawi - Klinik für Neurochirurgie, Universitätsklinikum Essen
  • P. R. Dammann - Klinik für Neurochirurgie, Universitätsklinikum Essen
  • S. Asgari - Klinik für Neurochirurgie, Universitätsklinikum Essen
  • D. Stolke - Klinik für Neurochirurgie, Universitätsklinikum Essen

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMI.08.03

The electronic version of this article is the complete one and can be found online at:

Published: May 30, 2008

© 2008 Sandalcioglu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Cavernous malformations (CMs) are not seldom located in the posterior fossa. We therefore aimed to analyze our patients operated on a posterior fossa CM with respect to the functional results and in order to analyze factors with impact on clinical outcome.

Methods: Between January 1990 and August 2007 35 consecutive patients with a CM of the posterior fossa underwent microneurosurgical resection in our institution. Age ranged from 11 to 62 years (mean 36.1 years). Most patients become symptomatic due to one or repetitive hemorrhages. The patient’s pre- and postoperative condition was classified according to the Frankel scale.

Results: In 21 patients the CM was located in the brainstem, in 11 patients in the cerebellar hemisphere and in 3 patients in the cerebellar peduncle. Most patients were operated via a suboccipital craniotomy in a semisitting position.

The postoperative condition was improved or unchanged in 31 patients and worse in 3 patients. One patient died due to a severe cerebellar hemorrhagic infarction. Brainstem lesions were found to have an increased risk of repetitive hemorrhages.

Conclusions: Acute onset of symptoms with subsequent neurological deterioration was the result of one or repetitive hemorrhages in symptomatic patients. Based on the increased risk of rehemorrhage and the gratifying functional results, surgery is indicated for symptomatic CMs. However, venous anomalies should remain intact in order to avoid a fatal outcome, especially in CMs of the posterior fossa.