Application of the Technique of Inferior Temporal Gyrus Resection for Microsurgical Treatment of Arteriovenous Malformation of the Fusiform Gyrus

Abstract

Arteriovenous malformations (AVMs) consist of multiple connections between arteries and veins without a capillary bed and are characterized by an early draining vein.^1,2 This pathology affects mainly young adults, and the morbimortality is caused mostly by rupture and hemorrhage.3, 4, 5, 6 In this Video 1, we present a case of a 29-year-old female patient presenting with a sudden severe headache. Magnetic resonance imaging demonstrated the presence of a left AVM located at the fusiform gyrus, above the tentorium cerebelli, and angiography depicted those temporal branches of the left middle cerebral artery and posterior lateral choroidal arteries irrigated the AVM. In contrast, the main venous drainage was to the transverse sinus. The patient was submitted for microsurgical treatment, and the technique involved the resection of the inferior temporal gyrus to reach the fusiform gyrus and, hence, the AVM. The inferior temporal gyrus is part of both the lateral surface and the basal surface of the brain.^7,8 Since the inferior temporal gyrus does not contain the main white matter tracts,^7,8 such as the sagittal stratum, its resection represents a surgical strategy to reach the fusiform and the lateral occipitotemporal gyri and their pathologies. The patient consented to the procedure and to the publication of their image. In addition, the study was accepted by the ethics committee. The patient evolved without complications or deficits.