小脳動静脈奇形摘出の要点

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  • Surgical Strategies and Techniques for Cerebellar Arteriovenous Malformations

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We discuss surgical strategies and techniques for the surgery of cerebellar arteriovenous malformations (AVMs), which have not been well documented compared with those of supratentorial AVMs. In the majority of cases, a lateral position is recommended to reduce venous pressure and provide comfortable access for the surgeons. Craniotomies should be large to expose the transverse sinus, sigmoid sinus, and cerebellar hemisphere of the affected side. Temporary occlusion of the posterior inferior cerebellar artery and/or the anterior inferior cerebellar artery can be easily achieved by retracting the cerebellum, and should be done before resecting of the nidus. The superior cerebellar artery is often hidden by the drainer in the operative field, and perioperative embolization or temporary occlusion via supra-tentorial root may be needed, especially in cases with high-flow AVMs. Dissection of the nidus should be done using the gliosis tissue and the hematoma cavity under proximal flow control. <br>

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  • 脳卒中の外科

    脳卒中の外科 42 (4), 233-237, 2014

    一般社団法人 日本脳卒中の外科学会

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