Surgical Treatment of Non-ruptured Giant Occipital Arteriovenous Malformations With Frequent Migraine-Like Headache-Two Case Reports-

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  • NAGATA Shinji
    Department of Neurosurgery, Kyushu University Graduate School of Medical Sciences
  • MORIOKA Takato
    Department of Neurosurgery, Kyushu University Graduate School of Medical Sciences
  • NATORI Yoshihiro
    Department of Neurosurgery, Aso Iizuka Hospital
  • SASAKI Tomio
    Department of Neurosurgery, Kyushu University Graduate School of Medical Sciences

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  • —Two Case Reports—

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Two patients with giant occipital arteriovenous malformation (AVM) underwent microsurgical treatment among 294 patients with intracranial AVM treated between 1981 and 2004. The patients were aged 52 and 65 years and showed common symptoms consisting of long-term frequent migraine-like headaches with visual aura and recent homonymous hemianopia. Common neuroimaging findings were abundant dural feeders plus feeders from the posterior, middle, and anterior cerebral arteries, and deep drainers to the galenic system. Both patients underwent preoperative staged embolization and total microsurgical removal of the nidus with a neuronavigation system. Both patients returned to ordinary life without the need for assistance. These findings emphasize that giant occipital AVM, even if unruptured, is surgically treatable with acceptable morbidity.<br>

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