Pial arteriovenous fistulas associated with multiple aneurysms presenting as intracerebral hemorrhage: a case report

Cai, Wenli; Gong, Jianping; Cheng, Bo-Chao; Qiao, Fang; Zhang, Wei; Zhu, Qingyi; Lan, Qing

doi:10.5137/1019-5149.jtn.9255-13.1

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…PAVFs are prone to rupturing due to their high and turbulent flow, which also likely explains the observed association with aneurysms of arterial feeders as well as venous varicosis. 10,11 In the event of rupture, the prognosis is poor with a mortality rate of 63%. 12 In the absence of an intervening nidus (unlike in AVM), complete disconnection of the fistula from its feeder(s) is the goal.…”

Section: Discussionmentioning

confidence: 99%

Dual Pathologies: Pial Arteriovenous Fistula in Combination with an Arteriovenous Malformation

Jannelli

Joswig

Bernava

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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Background A pial arteriovenous fistula (PAVF) is a rare neurovascular pathology consisting of a direct connection between one or more arterial feeders and a single venous channel. A PAVF was previously considered a subtype of an arteriovenous malformation (AVM). In the current literature these are distinguished as two independent entities with different clinical, physiopathologic, and structural characteristics. We report a case of a surgically treated 37-year-old woman with an extremely rare combination of an unruptured PAVF and AVM. Patient The AVM was mainly supplied by feeders of the middle cerebral artery and drained into the sigmoid sinus via an abnormally dilated and tortuous vein. Following its resection, intraoperative digital subtraction angiography (DSA) in the hybrid operating room revealed the presence of a PAVF that had not been noted during the preoperative planning. Hence the PAVF was completely disconnected as confirmed by DSA again. Conclusion This is the second reported case of an AVM-associated PAVF. Without the intraoperative DSA in the hybrid operating room, this unusual complex cerebrovascular entity would likely have been missed.

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Section: Discussionmentioning

confidence: 99%

Dual Pathologies: Pial Arteriovenous Fistula in Combination with an Arteriovenous Malformation

Jannelli

Joswig

Bernava

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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“…35 For instance, in 2014, Cai et al described PAVFs with multiple aneurysms in the feeding arteries due to hemodynamic stress. 36…”

Section: Feeding Arteriesmentioning

confidence: 99%

Intracranial non-galenic pial arteriovenous fistula: A review of the literature

Shi

et al. 2016

Interv Neuroradiol

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An intracranial non-galenic pial arteriovenous fistula (NGPAVF) is a direct connection between the intracranial artery and vein without a nidus. NGPAVFs are clinically rare, and the current understanding of NGPAVFs is limited. This study searched PubMed for the currently available literature, and a review of the relevant publications revealed that NGPAVFs require aggressive treatment, spontaneous occlusion is uncommon, and the prognosis following conservative treatment is poor. NGPAVFs can be divided into congenital and traumatic (including iatrogenic) types. Clinically, NGPAVFs are characterized by congestive heart failure, epilepsy, hemorrhage, mass effects, and nerve function deficits. For the imaging examination of NGPAVFs, digital subtraction angiography (DSA) is still the gold standard for diagnosis, although magnetic resonance DSA (MRDSA) and 4D computed tomography angiography (CTA) can also provide hemodynamic data in a non-invasive manner. Current treatments for NGPAVFs include surgical resection and endovascular embolization, both of which can yield clinical improvements. However, potential postoperative complications should be addressed, such as fatal bleeding due to rupture and deep vein thrombosis. Some studies recommend postoperative anticoagulation to reduce postoperative thrombotic complications.

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Pial arteriovenous fistulas associated with multiple aneurysms presenting as intracerebral hemorrhage: a case report

Cited by 2 publications

References 11 publications

Dual Pathologies: Pial Arteriovenous Fistula in Combination with an Arteriovenous Malformation

Dual Pathologies: Pial Arteriovenous Fistula in Combination with an Arteriovenous Malformation

Intracranial non-galenic pial arteriovenous fistula: A review of the literature

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