Title

Far Lateral Craniotomy and Occlusion In Situ of a Lateral Medullary Arteriovenous Malformation: 2-Dimensional Operative Video.

Department

Neurosurgery

Document Type

Article

Abstract

Lateral medullary arteriovenous malformations (AVMs) are located in the pia on the lateral medullary surface.1 They are supplied by arterial feeders from the V4 segment of the vertebral artery or posterior inferior cerebellar artery. A 64-yr-old man presented with leg spasms and progressively worsening gait. Angiography demonstrated a lateral medullary AVM. Patient consent was obtained for the surgical treatment of this lesion. Owing to its eloquent location, an occlusion in situ was performed without resection.1,2 This technique relies on the interruption of the arterial blood supply and occlusion of the draining vein to occlude the AVM. Intraoperative neurophysiological monitoring of motor and somatosensory evoked potentials was used, and the elimination of arteriovenous shunt flow was confirmed using indocyanine green videoangiography. Occlusion in situ preserves the flow to the delicate brainstem perforators and is safer than resection in selected cases like this one. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

Publication Date

4-16-2020

Publication Title

Oper Neurosurg (Hagerstown)

ISSN

2332-4260

PubMed ID

32297633

Digital Object Identifier (DOI)

10.1093/ons/opaa092

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