Arteriovenous malformations of vein of Galen: microsurgical treatment.

The surgical technic used at the neurosurgical clinic in Zürich in eradicating arteriovenous malformations of the vein of Galen is described. It is based on experience with nine cases. The surgical approach is made posteriorly. The right occipital lobe is retracted laterally from the falx cerebri. The multiple feeding vessels demonstrated in the angiogram are occluded; first, on the right side, then the left, and finally beneath the malformation. The draining vein of Galen is not occluded or removed. The use of the operating microscope is essential.