トピックス

小脳虫部上方脳動静脈奇形の手術

当科の内野晴登先生が書いた症例報告の論文がInterdisciplinary Neurosurgery誌に掲載されました。小脳虫部上方に位置する脳動静脈奇形(AVM)の症例です。術前の塞栓術に引き続いて、今回の手術ではoccipital transtentorial approach (OTA)を用いて安全にAVM摘出術を実施することができました。

Direct Surgery for Superior Vermian Arteriovenous Malformation

One of our staffs, Dr. Haruto Uchino published a case report on direct surgery for AVM located in the superior cerebellar vermis.
Uchino H, Akioka N, Tomita T, Kashiwazaki D, Kuwayama N, Kuroda S:
Removal of superior vermian arteriovenous malformation through the occipital transtentorial approach.
Interdisciplinary Neurosurgery 17:84-86, 2019

Abstract
Background: Arteriovenous malformations (AVMs) of the superior vermis are extremely rare. Although they
have a higher rate of hemorrhagic presentations than supratentorial AVMs, the surgical approaches for AVMs at this location remain controversial.
Case description: We report the case of a 73-year-old man with a hemorrhagic superior vermian AVM that was
treated with surgical resection through the occipital transtentorial approach (OTA). This approach, with a direct perpendicular view of the whole lesion, enabled us to control the feeding arteries safely and to finally accomplish a total resection.
Conclusions: The OTA is an elegant approach for the resection of superior vermian AVMs. Detailed assessment of angiographic features is mandatory in selecting an effective and safe surgical approach for posterior fossa AVMs depending on their location.

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