Peyton L. Nisson, BS,1 Robert T. Wicks, MD,2 Xiaochun Zhao, MD,2 Whitney S. James, MD, MHS,3 David Xu, MD,2 and Peter Nakaji, MD2

1College of Medicine, University of Arizona, Tucson; 2Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix; and 3High Desert Surgery Center, Prescott, Arizona


Abstract
Cavernous malformations of the brain are low-flow vascular lesions that have a propensity to hemorrhage. Extensive surgical approaches are often required for operative cure of deep-seated lesions. A 23-year-old female presented with a cavernous malformation of the left posterior insula with surrounding hematoma measuring up to 3 cm. A minimally invasive (mini-)pterional craniotomy with a transsylvian approach was selected. Endoscopic assistance was utilized to confirm complete resection of the lesion. The minipterional craniotomy is a minimally invasive approach that provides optimal exposure for sylvian fissure dissection and resection of many temporal and insular lesions.


**Intro music: "Daybreak" by Graeme Rosner

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