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- Department of Neurosurgery, Universidade Federal de São Paulo, Brazil
- Department of Radiology, Hospital Beneficencia Portuguesa de São Paulo, Brazil
- Department of Interventional Neuroradiology, Pontificia Universidade Católica de Campinas, Campinas, São Paulo, Brazil,
- Department of Neurosurgery, Bolivian Neurosurgery Institute, Cochabamba, Bolivia.
Correspondence Address:
Marcos Devanir Silva da Costa
Department of Neurosurgery, Universidade Federal de São Paulo, Brazil
DOI:10.25259/SNI_187_2021
Copyright: © 2021 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.How to cite this article: Silvio Sarmento Lessa1, Juan Alberto Paz-Archilla1, Bruno Loof Amorim1, Jose Maria Campos Filho1, Christiane Monteiro de Siqueira Campos2, Leonardo de Deus Silva3, Richard Gonzalo Parraga Choque4, Marcos Devanir Silva da Costa1, Feres Chaddad-Neto1. Microsurgical treatment for cerebellomesencephalic fissure arteriovenous malformations after multiple sessions of endovascular treatment. 10-May-2021;12:214
How to cite this URL: Silvio Sarmento Lessa1, Juan Alberto Paz-Archilla1, Bruno Loof Amorim1, Jose Maria Campos Filho1, Christiane Monteiro de Siqueira Campos2, Leonardo de Deus Silva3, Richard Gonzalo Parraga Choque4, Marcos Devanir Silva da Costa1, Feres Chaddad-Neto1. Microsurgical treatment for cerebellomesencephalic fissure arteriovenous malformations after multiple sessions of endovascular treatment. 10-May-2021;12:214. Available from: https://surgicalneurologyint.com/?post_type=surgicalint_articles&p=10800
Date of Submission
22-Feb-2021
Date of Acceptance
02-Apr-2021
Date of Web Publication
10-May-2021
Abstract
Background: Arteriovenous malformations (AVMs) are relatively uncommon congenital vascular anomalies, and only 7–15% of AVMs occur in the posterior fossa. Most posterior fossa AVMs clinically present with hemorrhage and are associated with a high risk of neurological deficits and mortality. These malformations are associated with a high incidence of flow-related aneurysms. Endovascular treatment of infratentorial AVMs is challenging in pediatric patients.
Case Description: We describe an 11-year-old female adolescent with cerebellar syndrome [
Conclusion: This illustrative video highlights the role of microsurgery as a feasible therapeutic strategy for complete resection of cerebellar AVMs after endovascular embolization.
Keywords: Arteriovenous malformation, Cerebrovascular, Microsurgery
Video 1
Annotation[1-7]
1) 0:00 – Title 2) 0:10 – Clinical Presentation 3) 0:33 – Neurological Examination 4) 0:42 – Neuroimage Findings/First Episode de Hemorrhage, CT Scan 5) 0:47 – Neuroimage Findings/First Episode de Hemorrhage 6) 0:55 – Neuroimage Findings/First Angiography 7) 1:19 – Neuroimage Findings/First Embolization 8) 1:28 – Neuroimage Findings/Second Hemorrhage 9) 1:49 – Neuroimage Findings/Second Angiography 10) 2:00 – Neuroimage Findings/Pre and Post Second Embolization 11) 2:09 – Neuroimage Findings/Third Embolization 12) 2:17 – Neuroimage Findings/Final Control of Third Embolization 13) 2:38 – Neuroimage Findings/Preoperative MRI 14) 2:50 – Neuroimage Findings/Preoperative Embolization 15) 2:56 – Neuroimage Findings/Post Embolization 16) 3:05 – Rationale for Procedure 17) 3:10 – Risks of the Procedure and Its Potentials Benefits 18) 3:37 – Alternatives and Why They Were Not Chosen 19) 3:48 – Positioning and Craniotomy 20) 3:57 – Key Surgical Steps 21) 4:12 – Subarachnoid Dissection and Feeding Coagulation, left side 22) 4:39 – Subarachnoid Dissection and Feeding Coagulation, right side 23) 4:54 – Clipping the Vermian Vein 24) 4:57 – Dissecting and Coagulating Tentorial Veins 25) 5:02 – Decompressing the Fourth Ventricle 26) 5:09 – Removal of Nidus and Onyx 27) 5:27 – Final Aspect 28) 5:43 – Disease Background 29) 6:20 – A Brief Review of Clinical and Image Outcome 30) 6:34 – Postoperative MRI 31) 6:42 – Postoperative Angiography 32) 6:51 – References
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
[Video 1]-Available on:
www.surgicalneurologyint.com
References
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