Grade 4 Temporal Arteriovenous Malformation: 2-Dimensional Operative Video.
The 2% to 4% annual rupture rate for arteriovenous malformations (AVMs) must be weighed against the risk of intervention during surgery within an eloquent brain region. Following a hemorrhage event, AVMs that were initially considered to be nonoperative or unfavorable for surgical resection can be intervened on to avoid the significantly elevated risk of rehemorrhage. This patient had a dominant temporal lobe Spetzler-Martin grade 4 AVM with deep venous drainage, representing a significant surgical challenge. The arachnoid plane microdissection was performed using microscissors but was tenuous, and it was necessary to define the draining vein and adjacent feeding arteries. This video demonstrates the major principles of AVM resection during the circumdissection and disconnection of the nidus. The postoperative angiography demonstrated complete resection. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.
Oper Neurosurg (Hagerstown)
Digital Object Identifier (DOI)
Hendricks, Benjamin K and Spetzler, Robert F, "Grade 4 Temporal Arteriovenous Malformation: 2-Dimensional Operative Video." (2020). Neurosurgery. 573.