[Surgical management of arteriovenous malformations in the posterior fossa]

The authors reported 3 cases of dural arterio-venous malformation (AVM) in the posterior fossa and discussed mainly on surgical treatment. Case 1: 53-year-old man was admitted to our clinic with complaints of amnesia, visual impairment, dysarthria and gait disturbance. Neurological examination on admission disclosed slight disturbance of consciousness, bilateral papilledema, horizontal nystagmus, dysarthria and ataxic gait. Contrast CT showed a presence of vermiform irregular high density with enlarged ventricle, indicating phlebectasia in the brainstem and the cerebellum. Angiograms revealed a presence of dural AVM at the straight sinus fed by branches of external carotid artery and vertebrobasilar circulation with appearance of phlebectasia due to increase in straight sinus pressure on later phase. Dural sinus isolation for the affected sinus was performed under large occipital craniotomy which was initially reported by Hugosson and Bergström. Case 2: 55-year-old man was admitted to our hospital with complaint of gait disturbance. Neurological examination at the time of admission disclosed signs of raised intracranial pressure and caudal cranial nerves disturbance. Bruit synchronized with radial pulse was audible over the left occipital region. Angiograms showed a presence of dural AVM at the left transverse and sigmoid sinus with many feeding arteries and abnormal venous returns. Isolation of the involved sinuses was performed as same as in case 1. Case 3: 39-year-old woman was admitted to our clinic with complaints of protrusion of eyes and uncomfortable machinery noise over the right retromastoid region.(ABSTRACT TRUNCATED AT 250 WORDS)