J Neurol Surg A Cent Eur Neurosurg 2018; 79(02): 173-176
DOI: 10.1055/s-0037-1608842
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Congenital Intracerebral Pial Arteriovenous Fistula: A Case Report

Shun-Bao Xin
1  Department of Radiology, Shandong Research Institute of Medical Imaging in Shandong University, Shandong, People's Republic of China
2  Department of Radiology, Affiliated Nanshan Hospital, Guangdong Medical College, Shenzhen, Guangdong Province, People's Republic of China
,
Guang-Bin Wang
1  Department of Radiology, Shandong Research Institute of Medical Imaging in Shandong University, Shandong, People's Republic of China
,
Wen-Juan Liu
3  Department of Radiology, Jining No.1 People's Hospital, Shandong, People's Republic of China
,
Qiang Liu
1  Department of Radiology, Shandong Research Institute of Medical Imaging in Shandong University, Shandong, People's Republic of China
› Author Affiliations
Further Information

Publication History

07 April 2017

08 September 2017

Publication Date:
14 December 2017 (online)

Abstract

Pial arteriovenous fistula (AVF) is an extremely rare intracranial vascular lesion. The pediatric type of AVF has a high percentage of varix, leading to mass effect with symptoms. We report a 12-year-old boy who was admitted due to sudden confusion and urinary incontinence. Computed tomography, magnetic resonance imaging, and magnetic resonance angiography (MRA) confirmed the diagnosis of congenital pial AVF. Digital subtraction angiography (DSA) revealed the lesion originating from the left middle cerebral artery and draining into the superior sagittal sinus. The AVF was successfully obliterated with six microcoils and 2.5-mL ethylene vinyl alcohol copolymer using a middle cerebral artery approach. This patient was discharged without neurologic deficits. The AVF became smaller and ultimately disappeared on the DSA and MRA at follow-up.