Cerebral arteriovenous malformation treatment by full transcranial neuroendoscopic approaches

Abstract

Background: Traditionally, cerebral arteriovenous malformations (cAVMs) are surgically treated with microscopy, and no cases receive full neuroendoscopy. We operated on two small cAVMs with hematoma under a neuroendoscope, and the two patients obtained excellent results. Objective: To explore the feasibility of treating cAVMs with a full transcranial neuroendo-scopic approach. Methods: The clinical data and operative techniques were collected and described for two patients who were diagnosed with cAVMs with hematoma and treated via a full transcranial neuroendoscopic approach. Results: In the two patients, the hematomas were successfully evacuated, and the AVMs were removed simultaneously; both patients had achieved excellent recoveries at discharge. Conclusion: To our knowledge, this is the first report in the literature to successfully treat cAVMs with hematoma with a full transcranial neuroendoscopic approach, showing that this approach is feasible and may be an alternative for small ruptured cAVMs. However, while the feasibility of attempting this approach was demonstrated, it was difficult to certify its obvious advantage. Nevertheless, we believe that this approach might be difficult for middle and large AVMs due to the shortcomings of neuroendoscopy. More cases and practice are needed to confirm the merits and limitations of this new approach for AVMs.