Marotta D, Hendricks BK, Shams-Amiri R, Watanabe G, Cohen-Gadol A. Resection of Brainstem Arteriovenous Malformations: Pearls and Pitfalls for Minimizing Complications.
World Neurosurg 2022;
159:348-361. [PMID:
35255634 DOI:
10.1016/j.wneu.2021.08.120]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/25/2021] [Indexed: 10/18/2022]
Abstract
BACKGROUND
The decision-making process surrounding resection of arteriovenous malformations (AVMs) in proximity to vital brainstem structures is a complex topic. Intricate vasculature in the setting of exquisite brainstem eloquence creates a high-risk operative landscape with the potential for devastating complications. Effective resections are driven by mastery of the relevant operative anatomy, preservation of pertinent vasculature, and technical experience and acumen.
METHODS
This article provides a narrative literature review on the resection of brainstem AVMs.
RESULTS
Operative anatomy and approaches to AVMs of the midbrain (anterior/posterior), pons (anterior/lateral), and medulla (anterior/lateral) are discussed herein, with a focus on pearls and pitfalls for minimizing complications during resection.
CONCLUSIONS
Careful consideration of the patient's clinical background, the natural history of the lesion, and expertise of the treating surgeon are paramount for improving the natural course of brainstem AVMs.
Collapse