Combined approach (stereotactic-microsurgical) to a paraventricular arteriovenous malformation. Case report.
The authors present one case of a 42 years old male patient who had a small right paraventricular arteriovenous malformation. At operation the patient was placed in the Talairach's stereotactic frame and, after performing a right carotid angiogram to locate the lesion exactly, a flexible cannula was inserted stereotactically, through a previous trephine hole, until the tip reached the AVM. Using a microsurgical technique and through a 1-2 cm corticotomy the cannula pathway was followed easily reaching the AVM. Total removal of the AVM was confirmed by a carotid angiogram, the patient was discharged without symptoms 7 days later. The authors propose that due to the special design of the Talairach's stereotactic frame, its application as a locating system for small and deep AVM's would greatly facilitate their removal using microsurgical techniques.