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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
› Institutsangaben
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Publikationsverlauf

07. April 2017

08. September 2017

Publikationsdatum:
14. Dezember 2017 (online)

    Lizenzen und Reprints

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.

Keywords

arteriovenous malformation - brain - magnetic resonance imaging - digital subtraction angiography
 

  • References

  • 1 Lasjaunias P, Manelfe C, Chiu M. Angiographic architecture of intracranial vascular malformations and fistulas—pretherapeutic aspects. Neurosurg Rev 1986; 9 (04) 253-263
    CrossrefPubMedGoogle Scholar
  • 2 Kraneburg UM, Nga VD, Ting EY. , et al. Intracranial pial arteriovenous fistula in infancy: a case report and literature review. Childs Nerv Syst 2014; 30 (02) 365-369
    CrossrefPubMedGoogle Scholar
  • 3 Cooke D, Tatum J, Farid H, Dowd C, Higashida R, Halbach V. Transvenous embolization of a pediatric pial arteriovenous fistula. J Neurointerv Surg 2012; 4 (04) e14
    CrossrefPubMedGoogle Scholar
  • 4 Yang WH, Lu MS, Cheng YK, Wang TC. Pial arteriovenous fistula: a review of literature. Br J Neurosurg 2011; 25 (05) 580-585
    CrossrefPubMedGoogle Scholar
  • 5 Hoh BL, Putman CM, Budzik RF, Ogilvy CS. Surgical and endovascular flow disconnection of intracranial pial single-channel arteriovenous fistulae. Neurosurgery 2001; 49 (06) 1351-1363 ; discussion 1363–1364
    CrossrefPubMedGoogle Scholar
  • 6 Yasargil M. Microneurosurgery. Vol. IIIA. AVM of the Brain, History, Embryology, Pathological Considerations, Hemodynamics, Diagnostic Studies, Microsurgical Anatomy. Stuttgart, Germany: Thieme; 1987: 125
    Google Scholar
  • 7 Santosh C, Teasdale E, Molyneux A. Spontaneous closure of an intracranial middle cerebral arteriovenous fistula. Neuroradiology 1991; 33 (01) 65-66
    CrossrefPubMedGoogle Scholar
  • 8 Wang YC, Wong HF, Yeh YS. Intracranial pial arteriovenous fistulas with single-vein drainage. Report of three cases and review of the literature. J Neurosurg 2004; 100 (2, Suppl Pediatrics): 201-205
    PubMedGoogle Scholar
  • 9 Hetts SW, Keenan K, Fullerton HJ. , et al. Pediatric intracranial nongalenic pial arteriovenous fistulas: clinical features, angioarchitecture, and outcomes. AJNR Am J Neuroradiol 2012; 33 (09) 1710-1719
    CrossrefPubMedGoogle Scholar
  • 10 Garel C, Azarian M, Lasjaunias P, Luton D. Pial arteriovenous fistulas: dilemmas in prenatal diagnosis, counseling and postnatal treatment. Report of three cases. Ultrasound Obstet Gynecol 2005; 26 (03) 293-296
    CrossrefPubMedGoogle Scholar
  • 11 Köroğlu M, Cil B, Yeşildağ A, Baykal B, Cekirge S, Oyar O. Prenatal diagnosis of intracranial pial arteriovenous fistula and endovascular treatment during the neonatal period. Diagn Interv Radiol 2006; 12 (02) 64-67
    PubMedGoogle Scholar
  • 12 Berenstein A, Ortiz R, Niimi Y. , et al. Endovascular management of arteriovenous malformations and other intracranial arteriovenous shunts in neonates, infants, and children. Childs Nerv Syst 2010; 26 (10) 1345-1358
    CrossrefPubMedGoogle Scholar
  • 13 Lownie SP, Duckwiler GR, Fox AJ, Drake CG. Endovascular therapy of nongalenic cerebral arteriovenous fistulas. In: Vinuela F, Halbach VV, Dion JE. , eds. Interventional Neuroradiology: Endovascular Therapy of the Central Nervous System. New York, NY: Raven Press; 1992: 87
    Google Scholar
  • 14 Nesbit GM, Barnwell SL. The use of electrolytically detachable coils in treating high-flow arteriovenous fistulas. AJNR Am J Neuroradiol 1998; 19 (08) 1565-1569
    PubMedGoogle Scholar
  • 15 Halbach VV, Higashida RT, Hieshima GB, Hardin CW, Dowd CF, Barnwell SL. Transarterial occlusion of solitary intracerebral arteriovenous fistulas. AJNR Am J Neuroradiol 1989; 10 (04) 747-752
    PubMedGoogle Scholar
  • 16 Metoki T, Mugikura S, Higano S. , et al. Subcortical calcification on CT in dural arteriovenous fistula with cortical venous reflux. AJNR Am J Neuroradiol 2006; 27 (05) 1076-1078
    PubMedGoogle Scholar
  • 17 Yu YL, Chiu EK, Woo E. , et al. Dystrophic intracranial calcification: CT evidence of ‘cerebral steal’ from arteriovenous malformation. Neuroradiology 1987; 29 (06) 519-522
    CrossrefPubMedGoogle Scholar