Abstract
Background:Posterior fossa arteriovenous malformations (AVMs) are rare vascular lesions, representing 7–15% of all intracranial AVMs. Although less frequent than supratentorial AVMs, they present higher rupture, morbidity, and mortality rates. Microsurgery, radiosurgery, and endovascular neurosurgery are treatment options for obliteration of those lesions. In this paper, we present a critical review of the literature about the management of posterior fossa AVM.Methods:A MEDLINE-based search of articles published between January 1960 and January 2014 was performed. The search terms: “Posterior fossa arteriovenous malformation,” “microsurgery,” “radiosurgery,” and “endovascular” were used to identify the articles.Results:Current data supports the role of microsurgery as the gold standard treatment for cerebellar AVMs. Brainstem AVMs are usually managed with radiotherapy and endovascular therapy; microsurgery is considered in cases of pial brainstem AVMs.Conclusions:Succsseful treatment of posterior fossa AVMs depend on an integrated work of neurosurgeons, radiosurgeons, and endovascular neurosurgery. Although the development of radiosurgery and endovascular techniques is remarkable, microsurgery remains as the gold standard treatment for most of those lesions.
Highlights
ConclusionsSuccsseful treatment of posterior fossa arteriovenous malformations (AVMs) depend on an integrated work of neurosurgeons, radiosurgeons, and endovascular neurosurgery
Posterior fossa arteriovenous malformations (AVMs) are rare vascular lesions, representing 7–15% of all intracranial AVMs
Posterior fossa arteriovenous malformations (AVMs) are for a rare group of vascular lesions located in the brainstem and cerebellum
Summary
Succsseful treatment of posterior fossa AVMs depend on an integrated work of neurosurgeons, radiosurgeons, and endovascular neurosurgery. The first report of these lesions date to1908 when Clingestein published a case report presenting the clinical manifestations of this entity.[28] In 1932 the first successful resection of a cerebellar AVM was performed by Olivercrona and Riives[20] in Sweden. Brainstem AVMs are often treated with radiosurgery and/ or endovascular therapy, given the high risks of major postoperative deficits after resection of AVMs in this region.[5] Currently, optimal treatment of infratentorial. We present a review of the management of posterior fossa AVMs. The roles of surgery, radiosurgery, and endovascular treatment as well as treatment outcomes are discussed based on the analysis of the current literature
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