Before dissection of the sylvian fissure and after opening the dura mater, a bolus of ICG is administered intravenously. ICG videoangiography is used for dynamic venography at 10 seconds after the depiction of branches of the middle cerebral artery.
Clear documentation of the sylvian vein was obtained via ICG videoangiography, even in cases of SAH with ambiguous anatomical topography attributable to clot under the superficial arachnoid membrane. ICG was able to differentiate between the sylvian veins of the frontal and temporal lobes, which allowed wide dissection of the sylvian fissure while preserving the veins.
ICG videoangiography is an easy and useful method for identifying the connections and tributaries of the superficial sylvian veins from a transsylvian approach. This method allows wide opening of the sylvian fissure while preserving the sylvian veins.