Abstract
Control of hemorrhage during AVM surgery is one of the key issues to prevent NPPB.
Inadequate procedures for hemostasis of feeders and drainers, socalled dilated capillaries
and arteries (moja moja blood vessels) that are located on the side facing the normal
brain, and inappropriate surgical strategies for intraoperative hemorrhage from these
blood vessels are frequently the main cause of the difficulty in achieving hemostatic
control. We conclude that it is important to aggressively reduce the occurrence of
intraoperative hemorrhage and prevent or minimize the dilatation of abnormal capillaries
and arteries due to inappropriate surgical procedures on the basis of the fundamental
surgical strategy, i.e., feeder ⇒ nidus ⇒ drainer. Adequately securing the length
and adequate coagulation of hemorrhagic blood vessel, employing a skillful bipolar
coagulator technique aimed at controlling intraluminal pressure and blood flow on
the central side, are believed to be key factors in hemorrhage treatment.
Key words
Arteriovenous Malformation - Intraoperative Bleeding - Dilated Capillaries
