Figure 12: The basic steps in AVM resection are demonstrated. The AVM was only apparent on the surface based on a questionable feeding artery versus draining vein leading to the subcortical AVM (upper left image-arrow). Pial dissection was performed (upper right photo). Subarachnoid dissection revealed an  en passage  artery (middle left image-arrow). Parenchymal disconnection exposed the borders of the nidus (middle right photo-arrows); the identity of the cortical vessel (blue arrow) is still unknown, however, it is carefully preserved. Embolized vessels were found and assisted with white matter dissection (lower left photo). The small draining veins were sacrificed after complete AVM disconnection. The initial cortical vessel (upper left image-red arrow) was finally identified as an  en passage  artery that was spared (lower right image).
{"Image Copyright": "\u00a9 2015 The Neurosurgical Atlas, All Rights Reserved"}