JoVE Encyclopedia of Experiments
Neuroscience
0 views • 7:25 min • August 29th, 2025
Begin with an anesthetized patient, positioned to ensure adequate cerebral venous drainage. The patient has a cerebral arteriovenous malformation (AVM), a lesion with abnormal artery-to-vein connections.
Incise the skin and connective tissue and remove the pericranium layer to expose the skull. Drill holes and connect them to create a bone flap.
Expose the dura mater, the outermost brain layer, and suture it to the skull to close the epidural space.
Open the dura to expose the AVM.
Identify the arteries feeding blood to the AVM and the veins draining blood away.
Use electrocautery to apply heat that seals the feeding arteries and blocks the inflow.
Dissect the AVM circumferentially, occlude the draining veins, and remove the AVM.
Use electrocautery and hemostatic agents to control residual bleeding.
Perform angiography to confirm complete AVM removal.
Close the dura, reposition the bone flap using a plating system, suture the scalp, and monitor the patient for recovery.
This procedure begins by performing a wide craniotomy at the AVM location. Ideally, the craniotomy site will be chosen to allow early access to cerebrospinal fluid cisterns for drainage if needed.
The patient is positioned to
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