Microsurgical resection of a huge pontine cavernoma with bulbar disturbance

Pontine cavernous malformations are rare vascular lesions that carry a significant risk of hemorrhage andneurological deficits because of their location within the brainstem. We describe the case of a young patientwho presented with bulbar symptoms secondary to a pontine cavernoma. Alongside the clinical details, wereview similar cases reported in the literature, including presentations such as trigeminal neuralgia and othercranial nerve syndromes arising from pontine lesions. The report outlines the surgical approach, intraoperativetechniques, and postoperative management in detail. Advanced neuromonitoring and careful selection of safeentry zones were critical to the operative plan. The patient experienced a favorable recovery, with improvementsnoted during rehabilitation and on follow-up imaging. In discussing this case, we highlight the balance betweenachieving maximal safe resection, often subtotal in brainstem surgery, and minimizing the risk of rehemorrhagewhile preserving neurological function.