Salcman M, Nudelman R W, Bellis E H
Neurosurgery. 1985 Nov;17(5):749-56. doi: 10.1227/00006123-198511000-00004.
Arteriovenous malformations (AVMs) of the superior cerebellar artery (SCA) are unusual and difficult lesions to treat, representing less than half of all AVMs located in the posterior fossa. Traditional approaches for surgical extirpation include the subtemporal transtentorial and suboccipital supracerebellar routes. On the basis of our recent experience with three SCA-supplied AVMs, we advocate an occipital transtentorial approach similar to that used for neoplasms of the pineal gland. Exposure of the AVM from above and in the midline provides superior visualization of the deep veins, the SCA arborization in the retrocollicular space, and the rostral cerebellum, without exposing the temporal lobe and the 4th nerve to surgical trauma in a narrow, confined space. Superior cerebellar AVMs that arise from the caudal branch of the SCA on the superolateral aspect of the hemisphere are more easily handled by standard suboccipital methods.
小脑上动脉（SCA）供血的动静脉畸形（AVM）较为罕见且治疗困难，占后颅窝所有AVM的比例不到一半。传统的手术切除方法包括颞下经小脑幕和枕下小脑上入路。基于我们近期对3例由SCA供血的AVM的治疗经验，我们提倡采用一种类似于松果体肿瘤手术的枕下经小脑幕入路。从上方和中线暴露AVM，能更好地观察深部静脉、四叠体后间隙内的SCA分支以及小脑上部，而无需在狭窄受限的空间中将颞叶和第4神经暴露于手术创伤之下。起源于半球上外侧面SCA尾侧分支的小脑上AVM，采用标准的枕下入路更容易处理。
