大脳半球間裂近傍AVMに対するContralateral Transfalcial Approach

概要

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In surgery for AVMs located adjacent to the interhemispheric fissure, it is often difficult to approach from the ipsilateral side due to obstruction by large drainers to the superior sagittal sinus. The contralateral transfalcial approach is useful for such cases, if the contralateral bridging veins do not interfere with the approach to the interhemisheric fissure along the falx. The main advantage of this approach is that it provides direct access to the main feeders from the anterior cerebral artery and a wider angle of view for dissection of the nidus than that of the ipsilateral approach. We experienced two cases with an arteriovenous malformation (AVM) located adjacent to the interhemispheric fissure resected using the contralateral transfalcial approach. In both cases, bridging veins as the drainers from the nidus would obstruct the ipsilateral approach to the main feeders from the anterior cerebral artery. The contralateral transfalcial approach was chosen in order to get the main feeders and dissect the nidus in the medial hemisphere. Resection of AVM nidus was successfully done, and postoperatively no neurological deficits remained in either case.
日本脳卒中の外科学会の論文
2001-09-30