抄録
A thalamic arteriovenous malformation (AVM) has a tendency to show frequent rebleeding and serious prognosis after initial bleeding. We reported a case with thalamic AVM which was removed through interhemispheric approach after preoperative embolization of the feeding arteries from the anterior choroidal artery (Acho A).
A 32-year-old female was admitted with semicomatose state and right hemiplegia. CT showed a left thalamic and intraventricular hemorrhage and, an emergency venticular drainage was performed. Angiography demonstrated a left thalamic AVM fed by the Acho A, perforators from P1 of the posterior cerebral arteries and the left posterior choroidal arteries. After 44 days from the onset, a preoperative embolization of the feeder from the Acho A was performed with PVA particles (150-250μm) and 20% ethanol. On the following day, direct surgery was carried out through the interhemispheric transcallosal approach and the nidus of AVM located in the left thalamus was electrocoagulated, guided by intraoperative angiography without any deterioration in her neurological states.
It can be said that a thalamic AVM is relatively easy to resect through interhemispheric approach after preoperative embolization of the feeding arteries from the Acho A.
