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57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Surgical and endovascular treatment for arteriovenous malformation around sylvian fissure

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  • corresponding author S. Kato - Department of Neurosurgery, Yamaguchi University School of Medicine
  • K. Kajiwara - Department of Neurosurgery, Yamaguchi University School of Medicine
  • M. Fujii - Department of Neurosurgery, Yamaguchi University School of Medicine
  • H. Fujisawa - Department of Neurosurgery, Yamaguchi University School of Medicine
  • S. Nomura - Department of Neurosurgery, Yamaguchi University School of Medicine
  • M. Suzuki - Department of Neurosurgery, Yamaguchi University School of Medicine

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 09.145

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc362.shtml

Published: May 8, 2006

© 2006 Kato et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Treatment of arteriovenous malformation (AVM) around sylvian fissure is challenging because of its anatomical location and complexity of feeding arteries. The purpose of this paper is focused on the surgical treatment and problem for sylvian fissure AVM.

Methods: Three patients with AVM around sylvian fissure were treated. They include two men and one woman and their age ranged from 18 to 54 years. All of these cases presented with intracerebral hemorrhage. Initial symptoms were headache in one, consciousness disturbance with hemiparesis in two. Spetzler and Martin grading were grade 3 in two cases and grade 4 in one. The niduses mainly seated in the sylvian fissure and extended to the basal ganglia and adjacent lobes. The feeding arteries were consisted of the branches of middle cerebral arteries. Two of them were treated by combination with embolization and surgical resection. One patient underwent embolization following stereotactic radiosurgery.

Results: Complete occlusion of the arteriovenous shunt was obtained in all cases. Normal branches of middle cerebral arteries were preserved. Glasgow Outcome Scale was good recovery in two and moderately disabled in one.

Conclusions: Sylvian fissure AVM was fed by multiple small feeders. In the treatment of AVM around sylvian fissure, meticulous identification of each branch of middle cerebral artery was important during the treatment.