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        Pial Arteriovenous Fistula with Giant Varices: Report of Two Cases with Good Surgical Outcome

        Morteza Faghih Jouibari,Mehdi Zeinali Zadeh,Masoud Khadivi,Alireza Khoshnevisan,Keisan Moazzeni,Sina Abdollahzade 대한뇌혈관외과학회 2014 Journal of Cerebrovascular and Endovascular Neuros Vol.16 No.2

        Pial arteriovenous fistulas (pAVF) are rare vascular lesions consisting ofone or more arterial connections to a single venous channel without anyintervening nidus of vessels or capillaries. Case 1 : A 65-year-old woman with a complaint of headache and lefthand paresthesia was referred to us. Magnetic resonance imagingshowed a large saccular lesion with signal void in the posterior part ofthe right sylvian fissure and catheter angiography showed a giant venousaneurysm fed by one branch of the middle cerebral artery (MCA) anddraining into the vein of Trolard. Case 2 : A 12-year-old boy was transferred to our hospital with a historyof sudden loss of consciousness and hemiplegia. Brain computed tomographyrevealed a massive hemorrhagic mass in the right hemisphere andcerebral angiography showed a pAVF with a large aneurysmal varix,which was fed by multiple branches of the right MCA and draining intothe superior sagittal sinus. Both patients underwent craniotomy and after ligation of vascular connections,aneurysmal varices were removed completely. Surgical resectioncan be a safe method for treatment of pAVFs, particularly in those withlarge varices.

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