tentorial notch arteriovenous fistula surgery

The AVF blood supply artery in this part is mostly from the cerebellar artery, the middle meningeal artery, the occipital artery and the meningeal branch of the vertebral artery. Drainage veins are also complicated, but it is not uncommon to drain the subarachnoid space to the cortical veins. Curing disease: Indication Cerebellar incision arteriovenous fistula surgery is applicable to: 1. A person with a history of bleeding or bleeding. 2. Patients with neurological dysfunction or neurological dysfunction are gradually aggravated. 3. Increased intracranial pressure due to venous return disorder, or cerebral angiography see drainage of the sinus has been occluded. 4. People with severe headaches or (and) intolerable vascular murmurs. Contraindications 1. No significant neurological dysfunction and history of bleeding. 2. Old and frail with other chronic diseases. Preoperative preparation The design of the incision during craniotomy is very important. It must be accurately positioned before surgery to design a surgical approach to meet the needs of surgical operations. Be prepared for blood. Surgical procedure 1. According to the position of the lesion in the position of the cerebellum, the incision site is determined. The former adopts the inferior approach, while the latter uses the occipital approach. 2. Gently lift the temporal lobe or occipital lobe, and the bridge vein encountered should be electrocoagulated. Reveal the cerebellum until its free edge. 3. After seeing the deformed vascular mass, carefully observe the angiographic radiograph to check the blood supply artery and the drainage vein. If the lesion is not large, and is not directly introduced into the venous sinus, it can be removed, the method is similar to transverse sinus AVF resection. If it is confirmed that the drainage vein is only injected into the cortical vein through the subarachnoid space, the drainage vein can be clamped and cut off close to the abnormal vascular traffic (this method is completely different from the AVM in the brain), often immediately When the vascular mass becomes smaller and collapses, it indicates that the abnormal shunt between the arteries and veins of the lesion has disappeared, and the operation can be terminated at this time (Grisoli treated the three methods with excellent results). The lesion can also be removed on this basis. 4. Complete the hemostasis after the hemostasis. complication The prevention and treatment of brain edema caused by poor venous return after operation should be strengthened. And pay attention to the occurrence of cerebrospinal fluid leakage.