Lateral inferior cerebellar peduncle approach
4 patients (3 woman and 1 man) who had a symptomatic dorsolateral brainstem cavernous malformation with radiographic and clinical evidence of hemorrhage, underwent excision via a far lateral suboccipital craniotomy through the foramen of Luschka and with an incision in the cerebellar peduncle.
On intraoperative examination, 2 of the 4 patients had hemosiderin staining on the surface of the peduncle. All lesions were completely excised and all patients had a good or excellent outcome (modified Rankin Scale scores of 0 or 1).
Case series of Deshmuk et al., illustrates that intrinsic lesions of the dorsolateral medulla can be safely removed laterally through the foramen of Luschka and the inferior cerebellar peduncle 1).