Hellow guys, Welcome to my website, and you are watching Lateral Supracerebellar Transtentorial Approach and In-situ Disconnection of a Thalamic AVM. and this vIdeo is uploaded by Daniel Walsh FRCS at 2020-02-05T11:00:10-08:00. We are pramote this video only for entertainment and educational perpose only. So, I hop you like our website.
| Name | Lateral Supracerebellar Transtentorial Approach and In-situ Disconnection of a Thalamic AVM |
| Video Uploader | Video From Daniel Walsh FRCS |
| Upload Date | This Video Uploaded At 05-02-2020 19:00:10 |
| Video Discription | This video forms part of a series that support the Royal College of Surgeons England Fellowship in Neurovascular Surgery at King's College Hospital, London. This video contains images of surgical procedures and viewer discretion is advised. Complete removal or Extirpation of the nidus is usually the microsurgical strategy employed to abolish arteriovenous shunting through vascular malformations of the brain and spinal cord. Where the malformation is located in a highly eloquent location or in cases of a diffuse nidus intimately related to functional cortex extirpation may be excessively morbid and alternatives to microsurgical treatment may need to be considered. In-situ disconnection of the arteriovenous malformation leaving the nidus in place has been reported as an alternative in such circumstances. Spetzler et al. described the “Pial Resection Technique” (1) for spinal vascular malformations which effectively achieves the goal of abolishing arteriovenous shunting by partial resection of a nidus. Han et al. have reported “Occlusion-in-situ”(2) for selected brainstem arteriovenous malformations. All published surgical series of such highly eloquent AVMs have been small and include still smaller numbers suitable for such a surgical strategy. In most practices the opportunity and indication for this approach are limited given that radiosurgery provides an excellent alternative for unruptured lesions of appropriate volume and trans-arterial and trans-venous endovascular techniques may be applied to malformation with an appropriate architecture. We present three cases where this technique has been applied in our practice and combined with intraoperative neurophysiological monitoring during temporary occlusion of irrigating arteries and draining veins to enhance safety. The criteria applied to select these cases we suggest are: 1.Small volume arteriovenous malformations in highly eloquent locations and/or with a diffuse nidus 2. All irrigating arteries must be accessible on the pial surface 3. All draining veins must be accessible on the pial surface. Pre-operative microcatheter exploration is advisable to demonstrate distal en-passant arterial supply as well as to assess alternative endovascular therapeutic options This is a little used but very valuable microsurgical technique for appropriately selected arteriovenous malformations. Neurosurgical Team: Daniel Walsh and Ahilan Kailaya-Vasan at King's College Hospital, London. Website: https://surgical-neurology.com Twitter: @KingsNeuro @DanielWalshFRCS |
| Category | Education |
| Tags | Arteriovenous Malformation | Science and Technology | Neurosurgery | Cerebrovascular Surgery | AVM | Brain | Brain surgery | Medical education | Brain haemorrhage | Health | Medicine | Surgery | Microsurgery | Brain hemorrhage | Neurosurgeon | Vascular Malformations |
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