Microsurgical resection of large parieto occipital avm

1. Microsurgical
resection of large
parieto-occipital
AVM
Presented by
Dr. S. M. Monir Hossain
Assistant Registrar
Clinical Neurosurgery

2. Particulars
of patient
• Name : Mrs. Sabina Yeasmin
• Age: 48 years
• Address : Cox’sbazar
• Normotensive, Nondiabetic
• Right handed

3. Presenting
features
• Sub Arachnoid Hemorrhage
• H/O Sudden unconsciousness
• Left sided Hemiparesis

4. Preoperative
imaging
MRI

5. Preoperative
imaging
CT Angiogram ACA PCA

6. Preoperative
imaging
MR Angiogram

7. Feeder Arteries
1. Rt. Posterior
Cerebral Artery
2. Rt. Anterior Cerebral
Artery
3. Rt. Posterior
Choroidal Artery
RPCA

8. Craniotomy
Flap

10. Excised AVM

11. Post operative

12. Complications • Per operative Extradural hemorrhage
during craniotomy-
– Effectively managed using bone wax
and extending the craniotomy
• Normal perfusion Pressure
Breakthrough
– Managed by lowering Blood pressure
using Combined alpha & beta blockers
• Post operative wound infection
– Managed conservatively using
antibiotics

15. THANK YOU