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Article Abstract
Background: Treating symptomatic deep-seated cerebral cavernous malformations (CCMs) is challenging due to surgical risks.
Case Description: A 37-year-old man underwent awake craniotomy with direct electrical stimulation (DES) for excision of a left posterior thalamic CCM. A transcortical transventricular approach through the superior parietal lobe enabled safe navigation around critical associative and projection white matter tracts.
Results: Postoperative MRI confirmed complete resection with preservation of major tracts, and the patient showed significant recovery at three months.
Conclusion: This case highlights the potential of awake surgery with DES as a safe and effective method for deep-seated CCMs traditionally deemed inoperable.
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