Parasplenial AVMに対するparieto-occipital interhemispheric approach

Abstract

We present the cases of 2 surgically treated patients with parasplenial arteriovenous malformations (AVMs). The AVMs fed through the pericallosal artery and posterior cerebral artery (PCA) and drained toward the vein of Galen. We adopted parieto-occipital interhemispheric approach to these AVMs with the patients in a lateral-semiprone position.Preoperative embolization of the feeding PCA branches was performed in 1 patient, and a contralateral interhemispheric approach to the AVM side was performed in the other patient because of the difficulty in the preservation of the bridging veins of the AVM side. Complete excision was accomplished in these patients without postoperative neurological deficits except transient memory disturbance in one case.The results of this experience indicate that parasplenial AVMs can be effectively treated by surgical resection via a parieto-occipital interhemispheric approach with, if necessary, preoperative embolization of the feeding PCA branches.