skip to main content

Brainstem Cavernoma – Surgical Indication — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardCerebrovascular DiseaseBrainstem Cavernoma – Surgical IndicationSCE Neurology

A surgically accessible pontine cavernous malformation has now caused a second MRI-confirmed symptomatic haemorrhage with new cranial-nerve deficits. What is the most appropriate management discussion?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Expert-centre discussion of complete microsurgical resection

Explanation lettering: E = shown as C · C = shown as E

E is correct. Contemporary consensus considers complete resection of a brainstem cavernous malformation reasonable after a second symptomatic bleed because rebleeding risk is higher, but only after expert review of accessibility and operative morbidity. Brainstem location is not an absolute prohibition. Cavernomas lack an AVM-like feeding artery, anticoagulation does not prevent haemorrhage, and radiosurgery is generally reserved for lesions with unacceptable surgical risk.

Reference: 2025 cavernous-malformation consensus recommendations: https://pmc.ncbi.nlm.nih.gov/articles/PMC12680281/