MRI:
This 41-year-old male presented with numbness of the right arm and the left side of the face. At the same time he complained of increasing dizziness and balance deficits. The neurological examination revealed hypesthesia, hypalgesia, and thermohypesthesia of the right arm and left side of the face. MR imaging showed a cavernous hemangioma in the pons in the region of the rhomboid fossa with signs of acute hemorrhaging.
Navigation:
The cavernous hemangioma was extirpated via a paramedial, supracollicular approach under neuronavigational guidance and multimodal monitoring of the cranial nerves VI, VII, VIII, IX, X, and XII.
Apart from a temporary episode of diplopia, the patient reported no neurological deficits postoperatively, in particular no facial palsy. The MR images taken 3 months after surgery confirmed complete removal of the cavernoma. Aside from a slightly uncertain gait, the patient does not display any neurological deficits.