A transcondylar approach to the arteriovenous malformation at the ventral cervicomedullary junction: report of three cases.
Arteriovenous malformation at the cerevicomedullary junction is a rare disorder, usually presenting with subarachnoid hemorrhage. The diagnosis is difficult because of its anatomical location. In addition, the ventral location of these arteriovenous malformations makes surgical treatment difficult. We describe three cases surgically treated with a transcondylar approach. The usefulness of digital subtraction angiography and magnetic resonance imaging is discussed. The technique of the transcondylar approach is also described, including C1 hemilaminectomy, unroofing of the transverse foramen of C1 to obtain control of the vertebral artery, and partial resection of the occipital condyle and lateral atlantal mass by extradural drilling. This approach provides direct access to the ventral portion of the cervicomedullary junction.
Hosoda
K
K
Department of Neurosurgery, Hyogo Brain and Heart Center, Himeji, Japan.
Fujita
S
S
Kawaguchi
T
T
Yamada
H
H
D000368:Aged; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D003399:Craniotomy / Q000379:methods*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008526:Medulla Oblongata / Q000098:blood supply*; D008875:Middle Aged; D009460:Neurologic Examination; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012422:Rupture, Spontaneous; D013116:Spinal Cord / Q000098:blood supply*; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000601:surgery