The Role of Intraoperative Neurophysiological Monitoring in Intracranial Cavernous Malformation Surgery: A Narrative Review.

Abstract

Cavernous malformations, also known as cavernous hemangiomas or cavernomas, are abnormal vascular lesions that can occur in various parts of the body, including intracranially. Surgical resection is often the preferred treatment for symptomatic or high-risk lesions located in eloquent or critical brain or spinal cord regions. However, cerebral cavernous malformation surgery presents unique challenges due to the risk of neurological deficits and the proximity of these lesions to vital neural structures. Intraoperative neurophysiological monitoring (IONM) plays a crucial role in enhancing surgical safety, minimizing complications, and optimizing patient outcomes. This review aimed to provide an overview of the various IONM techniques employed during cerebral cavernous malformations resection, particularly the relationship between intraoperative stimulation intensity and distance to fiber tracts or specific brain nuclei as monitored by IONM.