Pial arteriovenous fistula associated with vein of Galen dilatation in adult: A case report and MRI findings
Pial arteriovenous fistula (PAVF) is a rare intracranial vascular lesion where direct communication exists between one or more pial arteries and a cerebral vein, without an intervening nidus and located in the subpial meningeal space. When the drainage of PAVF involves a dilated, but already formed...
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Elsevier
2023-07-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043323002510 |
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| author | Duc Tan Vo, MD, PhD Tram Bich Thi Ha, MD Tu Ngoc Ho, MD Linh Hong Thi Nguyen, MD Hoa Viet Nguyen, MD |
| author_facet | Duc Tan Vo, MD, PhD Tram Bich Thi Ha, MD Tu Ngoc Ho, MD Linh Hong Thi Nguyen, MD Hoa Viet Nguyen, MD |
| author_sort | Duc Tan Vo, MD, PhD |
| collection | DOAJ |
| description | Pial arteriovenous fistula (PAVF) is a rare intracranial vascular lesion where direct communication exists between one or more pial arteries and a cerebral vein, without an intervening nidus and located in the subpial meningeal space. When the drainage of PAVF involves a dilated, but already formed vein of Galen (VOG), it should be distinguished from other vascular lesions located in this area, because their angio-architecture, natural history and treatment options are different. A 33-year-old female was admitted to our hospital with a history of new-onset generalized tonic-clonic seizures. Clinical examination showed no neurological deficit. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) depicted an arteriovenous fistula that was fed by the pial branches from left posterior cerebral artery and drained into the medial atrial vein before joining the VOG confluence and causing VOG dilatation. No nidus between the feeding arteries and draining vein, dural feeding arteries, or anatomical variations commonly seen with true vein of Galen aneurysmal malformations (VOGM) were found. These finding suggested a diagnosis of a PAVF associated with vein of Galen dilatation, which was confirmed by digital subtraction angiography. The patient was treated with transarterial glue embolization in 1 section, resulting in nearly complete occlusion of the fistula. Conventional MRI and MRA are noninvasive modalities that can provide valuable information regarding the anatomic localization of the fistula point, the feeding arteries, the venous sac, and their relationship with surrounding structures. These techniques are helpful for accurate diagnosis and treatment planning. |
| first_indexed | 2024-03-13T10:03:42Z |
| format | Article |
| id | doaj.art-e24b41a8f8d24c26b98c2c392a468561 |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-03-13T10:03:42Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-e24b41a8f8d24c26b98c2c392a4685612023-05-23T04:21:36ZengElsevierRadiology Case Reports1930-04332023-07-0118723912396Pial arteriovenous fistula associated with vein of Galen dilatation in adult: A case report and MRI findingsDuc Tan Vo, MD, PhD0Tram Bich Thi Ha, MD1Tu Ngoc Ho, MD2Linh Hong Thi Nguyen, MD3Hoa Viet Nguyen, MD4Department of Diagnostic Imaging, University Medical Center, Ho Chi Minh City, Vietnam; Department of Radiology, University of Medicine and Pharmacy, Ho Chi Minh City, VietnamDepartment of Diagnostic Imaging, University Medical Center, Ho Chi Minh City, Vietnam; Department of Radiology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Corresponding author.Department of Diagnostic Imaging, University Medical Center, Ho Chi Minh City, VietnamDepartment of Diagnostic Imaging, University Medical Center, Ho Chi Minh City, VietnamDepartment of Neurosurgery, University Medical Center, Ho Chi Minh City, UMC, VietnamPial arteriovenous fistula (PAVF) is a rare intracranial vascular lesion where direct communication exists between one or more pial arteries and a cerebral vein, without an intervening nidus and located in the subpial meningeal space. When the drainage of PAVF involves a dilated, but already formed vein of Galen (VOG), it should be distinguished from other vascular lesions located in this area, because their angio-architecture, natural history and treatment options are different. A 33-year-old female was admitted to our hospital with a history of new-onset generalized tonic-clonic seizures. Clinical examination showed no neurological deficit. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) depicted an arteriovenous fistula that was fed by the pial branches from left posterior cerebral artery and drained into the medial atrial vein before joining the VOG confluence and causing VOG dilatation. No nidus between the feeding arteries and draining vein, dural feeding arteries, or anatomical variations commonly seen with true vein of Galen aneurysmal malformations (VOGM) were found. These finding suggested a diagnosis of a PAVF associated with vein of Galen dilatation, which was confirmed by digital subtraction angiography. The patient was treated with transarterial glue embolization in 1 section, resulting in nearly complete occlusion of the fistula. Conventional MRI and MRA are noninvasive modalities that can provide valuable information regarding the anatomic localization of the fistula point, the feeding arteries, the venous sac, and their relationship with surrounding structures. These techniques are helpful for accurate diagnosis and treatment planning.http://www.sciencedirect.com/science/article/pii/S1930043323002510Magnetic resonance imagingPial arteriovenous fistulaVein of Galen dilatation |
| spellingShingle | Duc Tan Vo, MD, PhD Tram Bich Thi Ha, MD Tu Ngoc Ho, MD Linh Hong Thi Nguyen, MD Hoa Viet Nguyen, MD Pial arteriovenous fistula associated with vein of Galen dilatation in adult: A case report and MRI findings Radiology Case Reports Magnetic resonance imaging Pial arteriovenous fistula Vein of Galen dilatation |
| title | Pial arteriovenous fistula associated with vein of Galen dilatation in adult: A case report and MRI findings |
| title_full | Pial arteriovenous fistula associated with vein of Galen dilatation in adult: A case report and MRI findings |
| title_fullStr | Pial arteriovenous fistula associated with vein of Galen dilatation in adult: A case report and MRI findings |
| title_full_unstemmed | Pial arteriovenous fistula associated with vein of Galen dilatation in adult: A case report and MRI findings |
| title_short | Pial arteriovenous fistula associated with vein of Galen dilatation in adult: A case report and MRI findings |
| title_sort | pial arteriovenous fistula associated with vein of galen dilatation in adult a case report and mri findings |
| topic | Magnetic resonance imaging Pial arteriovenous fistula Vein of Galen dilatation |
| url | http://www.sciencedirect.com/science/article/pii/S1930043323002510 |
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