Left Occipital Craniotomy for Resection of Arteriovenous Malformation: 2-Dimensional Operative Video

Medial parieto-occipital arteriovenous malformations (AVMs) are fed by distal cortical posterior cerebral artery branches and are generally considered eloquent given the proximity to the calcarine fissure and paracentral lobule. This patient was a neurologically intact 12-yr-old girl with an incidentally discovered left occipital AVM. The patient underwent preoperative angiographic evaluation with embolization of a dominant posterior cerebral artery feeding vessel. The AVM was removed in the standard manner using circumdissection. Indocyanine green angiography was utilized to demonstrate disconnection of the AVM before sacrificing the draining veins. The AVM was removed entirely, as evidenced on postoperative angiography. The patient had a partial right hemianopsia after the operation but was otherwise neurologically intact. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.