Pial Arteriovenous Fistula with Multiple Venous Aneurysms Resembling a Vein of Galen Aneurysmal Malformation; Case Report and Review of Literature.
Aneurysmal malformations
Pial arteriovenous fistula
Vein of Galen
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
04
02
2019
revised:
06
04
2019
accepted:
06
04
2019
pubmed:
15
4
2019
medline:
14
1
2020
entrez:
15
4
2019
Statut:
ppublish
Résumé
Pial arteriovenous fistulas are abnormal vascular connections between arteries and the cranial venous system on the surface of the brain in the pia mater. In contrast to vein of Galen aneurysmal malformations, they lack a true vascular nidus and may only indirectly involve the vein of Galen. An 18-month-old boy was referred to us with a history of seizures, drowsiness, bulging cephalic veins, and cranial nerves palsy identified as vein of Galen aneurysmal malformation according to initial magnetic resonance imaging. Digital subtraction angiography showed a vertebrobasilar junction pial high-flow fistula between the basilar artery and anterior pontomesencephalic vein, causing retrograde flow, dilation, and tortuosity of the lateral and posterior mesencephalic vein as well as the vein of Galen. Endovascular treatment, including coil embolization of fistula site, was done successfully without complication resulting in recovery from previous symptoms and signs. If cerebral venous dilations are encountered, one must keep in mind that the location of the fistula may not be in close proximity to the dilated veins, especially when there is a suspicion for vein of Galen aneurysmal malformation. Other pathologies, such as pial arteriovenous fistula, in a region away from the site of the vein of Galen must be considered.
Sections du résumé
BACKGROUND
BACKGROUND
Pial arteriovenous fistulas are abnormal vascular connections between arteries and the cranial venous system on the surface of the brain in the pia mater. In contrast to vein of Galen aneurysmal malformations, they lack a true vascular nidus and may only indirectly involve the vein of Galen.
CASE DESCRIPTION
METHODS
An 18-month-old boy was referred to us with a history of seizures, drowsiness, bulging cephalic veins, and cranial nerves palsy identified as vein of Galen aneurysmal malformation according to initial magnetic resonance imaging. Digital subtraction angiography showed a vertebrobasilar junction pial high-flow fistula between the basilar artery and anterior pontomesencephalic vein, causing retrograde flow, dilation, and tortuosity of the lateral and posterior mesencephalic vein as well as the vein of Galen. Endovascular treatment, including coil embolization of fistula site, was done successfully without complication resulting in recovery from previous symptoms and signs.
CONCLUSIONS
CONCLUSIONS
If cerebral venous dilations are encountered, one must keep in mind that the location of the fistula may not be in close proximity to the dilated veins, especially when there is a suspicion for vein of Galen aneurysmal malformation. Other pathologies, such as pial arteriovenous fistula, in a region away from the site of the vein of Galen must be considered.
Identifiants
pubmed: 30981801
pii: S1878-8750(19)31053-8
doi: 10.1016/j.wneu.2019.04.061
pii:
doi:
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
245-248Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.