Name of the Procedure:

Surgery of Intracranial Arteriovenous Malformation (AVM); Infratentorial, Simple

Summary

This surgical procedure involves the removal or correction of an abnormal tangling of arteries and veins located in the infratentorial region of the brain. The procedure aims to prevent complications such as brain hemorrhage or other neurological issues.

Purpose

• Medical Condition: Treats arteriovenous malformation (AVM) in the infratentorial region of the brain.

• Goals:

  • Prevent brain hemorrhage
  • Alleviate symptoms such as headaches, seizures, or neurological deficits
  • Improve overall brain function

  Indications

• Recurrent headaches or seizures
• Neurological deficits such as weakness, difficulty speaking, or impaired vision
• History of brain hemorrhage due to AVM
• Radiological evidence of AVM in the infratentorial region

Preparation

• Patients may be instructed to fast for 8-12 hours before surgery.
• Medication adjustments may be necessary, particularly for blood thinners.
• Pre-operative imaging studies like MRI or CT scans.
• Blood tests and other assessments to evaluate overall health.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
2. Positioning: The patient is positioned appropriately to access the infratentorial region.
3. Incision: A surgical incision is made in the skull to access the brain.
4. Navigation: Advanced imaging techniques guide the surgeon to the AVM location.
5. Resection: The AVM is carefully removed or corrected to restore normal blood flow.
6. Closure: The incision is closed, and the patient is moved to recovery.

• Tools and Equipment: Surgical microscope, neuronavigation systems, electrosurgical units.

Duration

The procedure typically lasts between 3 to 6 hours, depending on the complexity of the AVM.

Setting

Performed in a hospital operating room with advanced neurosurgical facilities.

Personnel

• Neurosurgeon
• Anesthesiologist
• Surgical Nurses
• Support Staff

Risks and Complications

• Common Risks: Infection, bleeding, stroke
• Rare Risks: Brain swelling, neurological deficits, seizures
• Management includes immediate medical intervention and possibly extended hospitalization for more severe complications.

Benefits

• Reduction or elimination of symptoms like headaches and seizures
• Decreased risk of brain hemorrhage
• Improved overall neurological function
• Most benefits are realized within weeks to months post-surgery.

Recovery

• Patients typically stay in the hospital for a few days.
• Pain management includes medications to alleviate discomfort.
• Instructions may include avoiding strenuous activity for 6-8 weeks.
• Follow-up appointments to monitor recovery and ensure no recurrence of symptoms.

Alternatives

• Medical Management: Medications to control symptoms (less effective in preventing hemorrhage).
• Endovascular Embolization: Minimally invasive approach to block blood flow to the AVM.

• Stereotactic Radiosurgery: Targeted radiation to shrink the AVM over time.

• Pros and Cons:

  • Non-surgical options generally carry fewer immediate risks but may be less effective long-term.
  • Surgical intervention provides more definitive treatment but carries higher immediate risks.

Patient Experience

• During Procedure: Completely unconscious due to general anesthesia.
• After Procedure: Expect some post-operative pain and discomfort, managed with analgesics.
• Recovery: Gradual return to normal activities as per medical advice, with close monitoring for any signs of complications.