Surgical removal of cavernous angioma in the medulla oblongata. A case report.

Recent advances in neuroradiology have enabled us to approach cavernous angioma in the medulla oblongata, rather rare vascular lesion in the central nervous system. We describe a such surgical case without additional neurological symptoms and discuss surgical indications in this paper. A 61-year-old woman presented with vertigo and swallowing disturbance. T1-weighted magnetic resonance image (MRI) showed a low intensity mass in the dorsolateral portion of the medulla oblongata, and T2-weighted imaging revealed a hemosiderin rim surrounding the lesion. Angiography showed no abnormalities. Surgery using far lateral approach achieved complete removal of the mass and hematoma. Histological examination of the surgical specimen disclosed cavernous angioma. This case suggests that direct surgery can be recommended for cavernous angioma located in the dorsal or lateral medulla oblongata to remove the hematoma and angioma if bleeding clearly provokes neurological symptoms.