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V039: STIMULATION MAPPING GUIDED ENDOSCOPIC ENDONASAL TRANSCLIVAL RESECTION OF PONTINE CAVERNOMA
Won Kim, MD¹; Yashaar Hafizka, BA²; Maya Harary, MD¹; Anthony Wang, MD¹; ¹University of California Los Angeles Department of Neurosurgery; ²University of California Los Angeles David Geffen School of Medicine

We demonstrate endoscopic endonasal transclival resection of a ventral pontine cavernous malformation in a patient with progressive brainstem deficits, including internuclear ophthalmoplegia and tetraparesis. The video highlights the critical use of intraoperative subcortical stimulation to navigate distorted corticospinal tracts and define a safe myelotomy zone. Complete resection of the cavernous malformation and resolution of ophthalmoplegia were achieved, underscoring the utility of this approach and feasibility of functional mapping via the endonasal corridor. 

 

 

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