• Waleed Bin Ghaffar, Khalid Ahsan, Faraz Shafiq, and Ather Enam.
• Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan.
• J Coll Physicians Surg Pak. 2019 Dec 1; 29 (12): S74-S76.

AbstractThis case series summarises the successful management of two cases with cerebral arterio-venous malformation (AVM). In first patient, it was located superficially in right frontal cortex, while the second one had this in left parieto-temporal region. Both were excised successfully using awake craniotomy. The patients had their assessment and psychological preparation by neuro-anesthetist and neurosurgeon. Along with the routine monitoring, invasive arterial line, and bispectral index monitoring was used to monitor the sedative effect of propofol. Intraoperative analgesia was provided using scalp block. The anaesthetic management was helpful in facilitating intraoperative neurological monitoring using verbal and motor responses. Patients remained pain-free and hemodynamically stable during resection phase. The postoperative period showed adequate pain control, decreased postoperative nausea/vomiting and shorter length of stay in the hospital. Both patients had 100% obliteration of AVM confirmed via cerebral angiography.

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