An HBM looks like an extra-axial lesion, such as a vestibular schwannoma (VS) or a meningioma, on a radiological image. Seventy to 75% of HBMs have cystic or multi-cystic forms.
The characteristics of solid variants of HBMs are similar to those of intracranial arteriovenous malformations (AVMs).
Internal decompression and piecemeal resection may have devastating complications. Safe resection of large solid HBMs especially in the CPA requires surgical techniques similar to those for AVM surgery: pre-operative embolization, wide exposure, circumferential dissection, and en bloc removal.
We present a case of HBM in the CPA, in which complete resection was achieved without morbidity using the modified transcondylar fossa approach (TCFA) 1)