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| Name | Microsurgical Resection of a Complex Anterior Choroidal Arteriovenous Malformation |
| Video Uploader | Video From NEUROSURGERY Journal |
| Upload Date | This Video Uploaded At 27-02-2015 18:12:02 |
| Video Discription | Arteriovenous malformations (AVM) of the anterior choroidal artery are relatively rare lesions, representing ~2%-5% of intracranial AVMs. Due to the proximity to deep white matter structures and the involvement of the anterior choroidal artery, which also supplies the posterior limb of the internal capsule, thalamus, and optic chiasm/optic tract, microsurgical treatment of anterior choroidal AVMs is particularly challenging and high risk. Other options for management include endovascular embolization and radiosurgical treatment. The authors present a 32-year-old man who suffered from a 6-cm left medial temporal anterior choroidal AVM that had been previously treated with radiosurgery 4 years earlier. The patient presented with persistent right-sided weakness, peripheral visual field defects, and headaches. The malformation was unaffected by radiosurgery. The authors exposed this AVM through a left temporal transventricular transchoroidal approach and identified the hypertrophied anterior choroidal artery. This artery was preserved until the later stages of dissection to exclude its (or any of its branches) role as an en passage vessel. White matter feeders along the superior pole of the malformation, entangled with the basal ganglia, were carefully disconnected. Dissection of the feeders along the lateral wall of the brainstem was the most critical part of the operation. The malformation was disconnected along its feeders at the midbrain and the entire nidus was excised. Postoperatively, the patient had worsening of his right hemiparesis and a left ptosis, but both improved by the 3-month follow-up visit. |
| Category | Science & Technology |
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