Seven AVMs: Tenets and Techniques for Resection

354 Pages·2014·35.97 MB·English

by  Michael T. Lawton

Seven AVMs
Tenets and Techniques for Resection

Seven AVMs
Tenets and Techniques for Resection
Michael T. Lawton, MD
Professor of Neurological Surgery
Chief of Vascular and Skull Base Neurosurgery Program
Vice-Chairman, Department of Neurological Surgery
Tong-Po Kan Endowed Chair
University of California, San Francisco
Illustrations by Xavier Studio: Kenneth Xavier Probst, MA, CMI
Thieme
New York • Stuttgart
Thieme Medical Publishers, Inc.
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Executive Editor: Kay Conerly
Managing Editor: Judith Tomat and Barbara A. Chernow
Editorial Assistant: Sara D’Emic
Senior Vice President, Editorial and Electronic Product Development: Cornelia Schulze
Production Editor: Sean Woznicki
Illustrations by Xavier Studio: Kenneth Xavier Probst, MA, CMI
International Production Director: Andreas Schabert
Vice President, Finance and Accounts: Sarah Vanderbilt
President: Brian D. Scanlan
Printer: Sheridan Books
Library of Congress Cataloging-in-Publication Data
Lawton, Michael T., author.
Seven AVMs : tenets and techniques for resection / Michael T. Lawton ; illustrations by Kenneth Xavier Probst.
p. ; cm.
Seven arteriovenous malformations
Includes bibliographical references and index.
ISBN 978-1-60406-875-7 — ISBN 978-1-60406-876-4 (elSBN)
I. Title. II. Title: Seven arteriovenous malformations.
[DNLM: 1. Intracranial Arteriovenous Malformations—surgery. 2. Neurosurgical Procedures—methods. 3. Vascular Surgical
Procedures—methods. WL 355]
RD593
617.48—dc23 2014000129
Copyright ©2014 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. Any use,
exploitation, or commercialization outside the narrow limits set by copyright legislation without the publisher’s consent is illegal and
liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing or duplication of any kind, translating,
preparation of microfilms, and electronic data processing and storage.
Important note: Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment
and drug therapy may be required. The authors and editors of the material herein have consulted sources believed to be reliable in their
efforts to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the
possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowledge, neither the authors,
editors, nor publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained
herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use of
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contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindications for
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Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names
even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as
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Printed in the United States of America.
5 4 3 2 1
ISBN 978-1-60406-875-7
Also available as an e-book:
eISBN 978-1-60406-876-4
To William L. Young, my wingman in all things AVM related.
Although this extraordinary man of insight, creativity, and musical gifts could not develop
his life’s symphony further, he inspired so many others to ask challenging research questions,
“dare to know,” and enjoy the adventure.
Acknowledgments
The author thanks the following companies for their generous support of this book:
Carl Zeiss Meditec, Inc.
Dublin, California
Mizuho America, Inc.
Union City, California
Aesculap, Inc.
Center Valley, Pennsylvania
Contents
Foreword I by Albert L. Rhoton, Jr., MD ........................................................ ix
Foreword II by Robert F. Spetzler, MD ......................................................... xi
Preface .....................................................................................xiii
Section I: The Tenets
1 Exposure ....................................................................................3
2 Subarachnoid Dissection .....................................................................8
3 Draining Veins ..............................................................................13
4 Feeding Arteries ............................................................................18
5 Pial Dissection ..............................................................................22
6 Parenchymal Dissection .....................................................................26
7 Ependymal/Deep Dissection .................................................................30
8 Arteriovenous Malformation Resection .......................................................34
9 Intraoperative Arteriovenous Malformation Rupture ...........................................36
10 Surgeon Factors .............................................................................39
Section II: The Seven Arteriovenous Malformations
11 Frontal Arteriovenous Malformations .........................................................43
12 Temporal Arteriovenous Malformations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
13 Parieto-Occipital Arteriovenous Malformations ............................................. 115
14 Ventricular and Periventricular Arteriovenous Malformations ................................ 151
15 Deep Arteriovenous Malformations ........................................................ 181
16 Brainstem Arteriovenous Malformations .................................................... 229
17 Cerebellar Arteriovenous Malformations .................................................... 271
Section III: Selection Strategies
18 Patient Selection .......................................................................... 307
19 Multimodality Management Strategies and Treatment Selection .............................. 313
Conclusion ................................................................................ 319
Suggested Readings ........................................................................ 321
Index ..................................................................................... 325
vii