Retrocondylar Far-Lateral Approach for Resection of a Craniocervical Junction Hemangioblastoma.

Publication/Presentation Date

12-1-2019

Abstract

We present a case in which a retrocondylar far-lateral approach was utilized to resect a hemangioblastoma at the craniocervical junction. The patient was a 33-year-old man presenting with 2 months of symptoms referable to compression at the craniocervical junction (i.e., dizziness and gait instability). Though neurologically intact on exam, his imaging demonstrated a highly vascular cystic lesion dorsolateral to the medulla on the left consistent with a hemangioblastoma. Virtual reality software was critical to visualize the patient's lesion in relationship to the vertebral artery and draining vein ( Fig. 1 ). A far-lateral retrocondylar suboccipital craniectomy with a C1 hemilamiectomy permitted resection of this lesion. The operative strategy was to address the lesion similar to an arteriovenous malformation by detaching the lesion from its arterial feeders first, and then addressing the lesion's draining vein ( Fig. 2 ). Postoperative imaging demonstrated a gross-total resection and the patient had an uncomplicated postoperative course. This case demonstrates not only the lateral reach of a retrocondylar far-lateral approach; but also, clearly demonstrates an effective dissection strategy when approaching a hemangioblastoma. The link to the video can be found at: https://youtu.be/M0szMOdhjfE .

Volume

80

Issue

Suppl 4

First Page

349

Last Page

349

ISSN

2193-6331

Disciplines

Medicine and Health Sciences

PubMedID

31750058

Department(s)

Department of Surgery

Document Type

Article

Link to Full Text

Share

COinS