Abstract
Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto SP, Brazil: Department of Internal Medicine, Division of Radiology; Department of Surgery, Division of Pediatric Neurosurgery. Intracranial pial arteriovenous fistulas (AVFs) are an extremely rare cerebrovascular disease, accounting for 1.6% of all intracranial vascular malformations. It has been recognized as a pathological entity distinct from the arteriovenous malformations (AVMs), due to the direct connection between the feeder artery and the draining vein, without an intervening true nidus. Pial AVFs differ from dural AVFs in that their arterial supply derive from pial and cortical arteries and they are not involved by the leaflets of the dura-mater. They are in their majority considered to be congenital, but they may also occur sporadically or in association with congenital hereditary vasculopathies. The pial AVFs have a significant morbid-mortality secondary to its rupture when not treated. We report a case of intracranial pial fistula in a 2 years-old patient presenting seizures since the neonatal period, emphasizing the angiographic findings and the results of the endovascular treatment.
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