Interhemispheric Transfalcine Approach for Resection of Contralateral Arteriovenous Malformation: 2-Dimensional Operative Video.

The high versatility and efficacy of the contralateral interhemispheric approach is demonstrated in this resection of an arteriovenous malformation (AVM). This patient had a large AVM along the medial frontal lobe amenable to approach via the contralateral interhemispheric approach. The head was rotated to permit gravity retraction of the ipsilateral hemisphere to the AVM, avoiding the use of rigid retractors. Under the guidance of neuronavigation, the falx was opened to permit visualization of the AVM. Circumdissection with a disconnection of the nidus was performed in a standard fashion. Postoperative angiography confirmed complete removal of the AVM. 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.