• José Ernesto Chang M, AlejandroSebastián AníbalSADepartment of Neurosurgery, Universidade Federal de Sao Paulo, São Paulo-SP, Brazil., Samantha Lorena Paganelli, Evelyn Judith Vela Rojas, Ana Paula Viera Neves, Marcos Devanir Da Costa, Hugo Leonardo Dória-Netto, Campos FilhoJosé MariaJMDepartment of Neurosurgery, Universidade Federal de Sao Paulo, São Paulo-SP, Brazil; Hospital Beneficência Portuguesa de São Paulo, São Paulo-SP, Brazil., and Feres Chaddad-Neto.
• Department of Neurosurgery, Universidade Federal de Sao Paulo, São Paulo-SP, Brazil.
• World Neurosurg. 2021 Dec 1; 156: 27.

AbstractCerebral cavernous malformations, also known as cavernomas, are vascular abnormalities of the brain that are clinically associated with a variety of neurologic symptoms that may include hemorrhagic strokes. They are the most common vascular abnormality, representing 10%-25% of all vascular malformations.1 Lesions associated with cavernomas include developmental venous anomalies, capillary telangiectasias, and other vascular malformations2 but not intracranial aneurysms. The latter association is extremely rare; in fact, there is only 1 case reported in the literature, in which the cavernoma was obscured by the presence of a cerebral hemorrhage and an unruptured aneurysm, which was presumed to be the primary cause of the bleeding, thereby misleading the surgeons to treat only the aneurysm.2 There are different alternatives for the management of different types of lesions.3-5 In this 3-dimensional operative video (Video 1), we present a case of a cavernoma associated with hemorrhage coexisting with an unruptured aneurysm in which we achieved complete resolution of both with microsurgical treatment through a pterional approach.6 The patient consented to publication of images.Copyright © 2021 Elsevier Inc. All rights reserved.

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