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Arteriovenous malformations (AVMs) consist of multiple connections between arteries and veins without a capillary bed and are characterized by an early draining vein. 1 , 2 This pathology affects mainly young adults, and the morbimortality is caused mostly by rupture and hemorrhage. 3-6 In this Video 1, we present a case of a 29-year-old female patient presenting with a sudden severe headache. Magnetic resonance imaging demonstrated the presence of a left AVM located at the fusiform gyrus, above the tentorium cerebelli, and angiography depicted those temporal branches of the left middle cerebral artery and posterior lateral choroidal arteries irrigated the AVM. In contrast, the main venous drainage was to the transverse sinus. The patient was submitted for microsurgical treatment, and the technique involved the resection of the inferior temporal gyrus to reach the fusiform gyrus and, hence, the AVM. The inferior temporal gyrus is part of both the lateral surface and the basal surface of the brain. 7 , 8 Since the inferior temporal gyrus does not contain the main white matter tracts, 7 , 8 such as the sagittal stratum, its resection represents a surgical strategy to reach the fusiform and the lateral occipitotemporal gyri and their pathologies. The patient consented to the procedure and to the publication of their image. In addition, the study was accepted by the ethics committee. The patient evolved without complications or deficits., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Cavernous malformations (CMs) are rare and often oligosymptomatic vascular lesions. The main symptoms include seizure and focal neurologic deficits. 1-3 Depending on the symptomatology, location, size, and risk factors for bleeding, like the presence of a developmental venous anomaly, CMs can be highly morbid. Thus surgical resection may be considered. Deep-seated and eloquent CMs, like those in the uncus, can be challenging. 4 , 5 In Video 1, we present a 23-year-old male adult who developed focal seizures (i.e., oral automatisms) after an episode of sudden intense headache 1 year ago. His neurologic examination was unremarkable. The patient consented to the procedure and publication of his image. Nevertheless, his magnetic resonance images showed an uncal 2-cm Zabramski type I CM. We exposed the insula and its limen through a right pterional craniotomy and transsylvian corridor. During the video, we discuss the surgical nuances to access and resect this CM lesion en bloc while preserving important vascular structures and white matter tracts. Postoperative neuroimaging demonstrated total resection. In postoperative day 1, the patient had 1 episode of generalized seizure and evolved with contralateral hemiparesis. The patient had a good recovery and was discharged on postoperative day 21. At the 6-month follow-up, the patient had no new epileptic events and presented complete weakness improvement. Through this minimally invasive and well-known surgical corridor, we preserve the mesial and lateral portion of the temporal lobe, reducing the risk of lesions to the Meyer loop and limbic association area., (Copyright © 2024 Elsevier Inc. All rights reserved.)