Augmented reality–assisted microsurgical resection of brain arteriovenous malformations: illustrative case

Lea Scherschinski, Ian T. McNeill, Leslie Schlachter, William H. Shuman, Holly Oemke, Kurt A. Yaeger, Joshua B. Bederson

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


BACKGROUND Arteriovenous malformations (AVMs) of the brain are vessel conglomerates of feeding arteries and draining veins that carry a risk of spontaneous and intraoperative rupture. Augmented reality (AR)-assisted neuronavigation permits continuous, real-time, updated visualization of navigation information through a heads-up display, thereby potentially improving the safety of surgical resection of AVMs. OBSERVATIONS The authors report a case of a 37-year-old female presenting with a 2-year history of recurrent falls due to intermittent right-sided weakness and increasing clumsiness in the right upper extremity. Magnetic resonance imaging, magnetic resonance angiography, and cerebral angiography of the brain revealed a left parietal Spetzler-Martin grade III AVM. After endovascular embolization of the AVM, microsurgical resection using an AR-assisted neuronavigation system was performed. Postoperative angiography confirmed complete obliteration of arteriovenous shunting. The postsurgical course was unremarkable, and the patient remains in excellent health. LESSONS Our case describes the operative setup and intraoperative employment of AR-assisted neuronavigation for AVM resection. Application of this technology may improve workflow and enhance patient safety.

Original languageEnglish
Article numberCASE21135
JournalJournal of Neurosurgery: Case Lessons
Issue number25
StatePublished - Jun 2022


  • AVM
  • arteriovenous malformation
  • augmented reality
  • image-guided surgery
  • neuronavigation
  • virtual reality


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