Although the importance of neuro-endovascu-lar therapy and radiosurgery in the management of arteriovenous malformations (AVMs) has been increasing steadily over the past 5 years, microsurgical excision still retains a primary role, particularly as it is the only treatment option that immediately eliminates the risk of bleeding. The frequent intimate relationship of AVMs to eloquent brain tissue has rendered neuronavigation techniques useful in surgical management, in an effort to reduce post-operative neurological morbidity.
Image-guided surgery based on a pre-opera-tively acquired MR scan allows pre-operative planning and identification of the ideal location and size of the skin incision and bone flap. For lesions with minimal gyral representation, it allows precise localization of the AVM through a small, optimally placed craniotomy. More importantly, it allows planning of the optimal surgical trajectory to the AVM, maximally avoiding eloquent brain tissue, particularly
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.