Acquired pial arteriovenous fistula following cerebral vein thrombosis.
BACKGROUND
We report a unique case of an acquired pial arteriovenous fistula occurring after an asymptomatic thrombosis of a superficial cerebral vein.


METHODS
A cerebral angiogram performed in a 51-year-old man with subarachnoid hemorrhage revealed a 10-mm ruptured anterior communicating artery aneurysm and a thrombosed left superficial middle cerebral vein. Coil embolization of the anterior communicating aneurysm was performed. Follow-up angiography 18 months later revealed a new, asymptomatic, pial arteriovenous fistula between the previously thrombosed left superficial middle cerebral vein and a small sylvian branch of the left middle cerebral artery.


CONCLUSIONS
This case provides evidence that pial arteriovenous fistulas may develop as acquired lesions and furthermore may rarely follow cerebral vein thrombosis. Several cases of dural arteriovenous fistulas, as well as a single case of a mixed pial-dural arteriovenous fistula, occurring after dural sinus thrombosis have been reported previously. However, to our knowledge, this is the first report of an acquired pial arteriovenous fistula following a cerebral vein thrombosis.
Phatouros
C C
CC
Division of Interventional Neurovascular Radiology, University of California at San Francisco Medical Center 94143-0628, USA. con.phatouros@radiology.ucsf.edu
Halbach
V V
VV
Dowd
C F
CF
Lempert
T E
TE
Malek
A M
AM
Meyers
P M
PM
Higashida
R T
RT
D017542:Aneurysm, Ruptured / Q000150:complications; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D004388:Dura Mater / Q000098:blood supply; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications; D020767:Intracranial Thrombosis / Q000150:complications*; D008297:Male; D008576:Meningeal Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology; D010841:Pia Mater / Q000098:blood supply*; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology