Resection of pontine cavernous malformation by the full neuroendoscopic telovelar approach

Abstract Introduction: Lesions located in the fourth ventricle and/or pontine tegmentum were treated by telovelar approach under a microscope. However, it is difficult to access upper fourth ventricle from caudal to rostral without removal posterior arch of the atlas due to the vertical working angle of microscope. Neuroendoscope has a good degree of freedom in surgery and can reach this area easily. We tried to remove pontine cavernous malformation by full neuroendoscopic telovelar approach and the results was excellent. Clinical Presentation: Two women presented with dizziness and numbness and were diagnosed as pontine cavernous malformation. The cavernous malformations were removed by a full neuroendoscopic telovelar approach without removal of the posterior arch of the atlas. Conclusion: Neuroendoscope can remedy the flaws of microscopy and can provide greater application for the telovelar approach in pons and fourth ventricle.