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| Name | Combined Trans-Sylvian Trans-Ventricular Approach to a Hippocampic AVM |
| Video Uploader | Video From NEUROSURGERY Journal |
| Upload Date | This Video Uploaded At 31-05-2016 19:48:56 |
| Video Discription | Arteriovenous malformations of the mesial temporal lobe are complex vascular lesions. Three sets of anatomical circumstances constellate to earn them this reputation: (1) they localize to an important part of the limbic system (amygdala, hippocampus, and parahippocampal gyrus) that controls emotions, learning, and memory; (2) they drain into the deep venous system; and (3) they are supplied by the cisternal and/or plexal segments of either or both of the anterior choroidal artery (AchA) and posterior cerebral artery (PCA). Despite the current advancements in radiosurgical and endovascular treatments for these AVMs, surgery remains a viable and, for some patients, the best treatment option. In this 3-dimensional video, we present the case of a 20-year-old, right-handed female with an unruptured, 2.8-cm, right-sided hippocampic AVM. The lesion was supplied by branches of the AchA and PCA and drained into the deep venous system. Functional MRI was used to evaluate language and memory. All treatment options were discussed with the patient, who opted for surgery. After embolization, a combined trans-sylvian and trans-ventricular/trans-choroidal approach was used to completely resect the AVM. The trans-sylvian component allowed for early proximal control of both feeding vessels, and identification and preservation of en passage vessels and crucial perforators that were supplying the superior and medial structures. The patient remained neurologically intact. We will briefly discuss the nuances of this approach to the medial temporal region and the hippocampus. |
| Category | Science & Technology |
| Tags | Science & Technology Download MP4 | Science & Technology Download MP3 | Science & Technology Download MP4 360p | Science & Technology Download MP4 480p | Science & Technology Download MP4 720p | Science & Technology Download MP4 1080p |
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