Pial arteriovenous fistula in the posterior fossa

Guerra, Luciana Rossi; Barbosa, Leandro de Assis; Barbosa, Lívia Guidoni de Assis; Pimentel, Derval; Leite, Fabrízio Isaac Schawb

doi:10.1590/s0004-282x2011000500028

Arq. Neuro-Psiquiatr.

2011

DOI: 10.1590/s0004-282x2011000500028

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Pial arteriovenous fistula in the posterior fossa

Luciana Rossi Guerra¹,

Leandro de Assis Barbosa

Lívia Guidoni de Assis Barbosa³

et al.

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Cited by 7 publications

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“…Reports of pial arteriovenous fistulas (AVFs) that occur in the posterior fossa are quite rare, occasionally appearing in general pial AVF case series or as individual case reports; [1][2][3][4][5][6] in particular, direct AVFs originating off the basilar artery have not previously been reported. We present the case of a child with a basilar pial AVF with mass effect and progressively accelerating neurological decline and report on its management and outcome.…”

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confidence: 99%

Segmental upper mid-basilar artery sacrifice in a child using a Micro Vascular Plug device for treatment of a basilar arteriovenous fistula compressing the brainstem

2017

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This case demonstrates a rare pathology of basilar artery pial arteriovenous shunting presenting with acutely progressive symptoms of brainstem compression, in which we applied a polytetrafluoroethylenecoated embolic device to achieve short-segment upper mid-basilar artery sacrifice. In addition to presenting a rare form of basilar arteriovenous fistula (AVF) (likely related to hereditary hemorrhagic telangiectasia) and discussing the extreme management challenges, this case demonstrates the unusual but successful application of a novel neurovascular device. Unanswered questions include the mechanism of development of this pathology and the optimum post-embolization anticoagulation plan.

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confidence: 99%

Segmental upper mid-basilar artery sacrifice in a child using a Micro Vascular Plug device for treatment of a basilar arteriovenous fistula compressing the brainstem

2017

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Pediatric non-galenic pial arteriovenous fistula’s characteristics and outcomes: a systematic review

Thrash,

Hale,

Feldman

et al. 2024

Childs Nerv Syst

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Introduction Pediatric non-galenic pial arteriovenous fistulas (pAVFs) are rare vascular malformations that are characterized by a pial arterial-venous connection without an intervening capillary bed. Outcomes and treatment strategies for pAVFs are highly individualized, owing to the rarity of the disease and lack of large-scale data guiding optimal treatment approaches. Methods We performed a systematic review of pediatric patients (< 18 years at diagnosis) diagnosed with a pAVF by digital subtraction angiogram (DSA). The demographics, treatment modalities, and outcomes were documented for each patient and clinical outcome data was collected. Descriptive information stratified by outcome scores were classified as follows: 1 = excellent (no deficit and full premorbid activity), 2 = good (mild deficit and full premorbid activity), 3 = fair (moderate deficit and impaired activity), 4 = poor (severe deficit and dependent on others), 5 = death. Results A total of 87 studies involving 231 patients were identified. Median age at diagnosis was 3 years (neonates to 18 years). There was slight male preponderance (55.4%), and 150 subjects (81.1%*) experienced excellent outcomes after treatment. Of the 189 patients treated using endovascular approaches, 80.3% experienced excellent outcomes and of the 15 patients surgically treated subjects 75% had an excellent outcome. The highest rate of excellent outcomes was achieved in patients treated with Onyx (95.2%) and other forms of EvOH (100%). High output heart failure and comorbid vascular lesions tended to result in worse outcomes, with only 54.2% and 68% of subjects experiencing an excellent outcome, respectively. *Outcomes were reported in only 185 patients. Conclusion pAVFs are rare lesions, necessitating aggregation of patient data to inform natural history and optimal treatment strategies. This review summarizes the current literature on pAVF in children, where children presenting with heart failure as a result of high flow through the lesion were less likely to experience an excellent outcome. Prospective, large-scale studies would further characterize pediatric pAVFs and enable quantitative analysis of outcomes to inform best treatment practices.

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Surgical Disconnection of a Residual Pediatric Pial Arterio-Venous Fistula Following Partial Embolization: A Case Study

et al. 2020

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Pial arteriovenous fistula in the posterior fossa

Cited by 7 publications

References 3 publications

Segmental upper mid-basilar artery sacrifice in a child using a Micro Vascular Plug device for treatment of a basilar arteriovenous fistula compressing the brainstem

Segmental upper mid-basilar artery sacrifice in a child using a Micro Vascular Plug device for treatment of a basilar arteriovenous fistula compressing the brainstem

Pediatric non-galenic pial arteriovenous fistula’s characteristics and outcomes: a systematic review

Surgical Disconnection of a Residual Pediatric Pial Arterio-Venous Fistula Following Partial Embolization: A Case Study

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