J Neurol Surg A Cent Eur Neurosurg 2013; 74(03): 187-191
DOI: 10.1055/s-0032-1333421
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Mini Supraorbital Approach to Inferior Frontal Lobe Cavernous Malformations: Case Series

Michael E. Ivan
1   Department of Neurosurgery, UCSF, San Francisco, California, United States
Michael T. Lawton
1   Department of Neurosurgery, UCSF, San Francisco, California, United States
› Author Affiliations
Further Information

Publication History

17 May 2012

11 August 2012

Publication Date:
19 March 2013 (online)


Background Anterior surgical approaches to the inferior frontal lobe require large craniotomies with long incisions and some risk of cosmetic defects and surgical morbidity. A mini supraorbital keyhole approach is an alternative to these larger craniotomies. Inferior frontal lobe cavernous malformations are an excellent target for this minimally invasive approach, and we present our experience with two patients.

Methods Two patients with inferior frontal lobe cavernous malformations underwent elective resection of their cavernous malformations through a mini supraorbital craniotomy. The subfrontal exposure opened widely after draining cerebrospinal fluid (CSF) from the carotid cistern to relax the brain. Hemosiderin staining helped identify the underlying cavernous malformations.

Results Both lesions were completely resected. No intraoperative complications, CSF leaks, or neurological deficits were observed.

Conclusion The mini supraorbital keyhole craniotomy with microsurgical technique and neuronavigation is an effective approach for treating cavernous malformations in the inferior frontal lobe. This minimally invasive approach reduces incision size, craniotomy size, and associated complications while enhancing cosmetic outcomes.

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