Minimally invasive surgery for cerebral AVM in the eloquent cortex

The treatment of arteriovenous malformation (AVM) is still a challenging problem in the neurosurgical field. The usual operative procedure has been the removal of the AVM by sucking the gliosis which surrounds it. However, by using such a method in the functional area, especially the sensory and motor cortex, it has been impossible to remove the AVM without postoperative neurological deficit. Recent reports have shown that a 1 mm thickness of the brain around a large AVM is non-functioning;(1,2) therefore, we aimed to remove only the AVM without sucking the brain.