title: Surgical treatment of the intracranial pial arteriovenous fistula.
abstract: BACKGROUND
  Pial arteriovenous fistula (PAVF) is a rare vascular condition comprising of one or more arterial vessels that are in direct communication with the draining veins. The condition is also characterized by the absence of a nidus. Due to high blood flows, varicose systems adjacent to the fistula appear. The key characteristic of the arteriovenous direct transition is that it offers a treatment option in which interruption of the blood flow can occur without removing the entire lesion. This study presents two cases of PAVF.
  
  
  METHODS
  The first case is of a 59-year-old male with lesions in the frontal region, fed by a branch of the right anterior cerebral artery and drained by the frontal basal vein to the sphenoparietal sinus. The second case is of a 3-year-old child with a lesion in the right anterior frontal lobe, fed by a branch of the right middle cerebral artery, which drains into the Trolard vein and was associated with large a venous varix.
  
  
  CONCLUSIONS
  PAVF is a disease characterized by its rarity, and knowledge of PAVF's clinical presentation is of vital importance in early diagnosis. The treatment of the condition consists of an occlusion of the supply vessel, which can be done by endovascular, microsurgical, or both procedures. Both the cases were successfully treated by microsurgical procedure.
authors.affiliation: Department of Neurosurgery, Santa Casa de Misericordia Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Warley Carvalho
authors.initials: WC
authors.lastname: da Silva Martins
authors.affiliation: Department of Neurosurgery, Santa Casa de Misericordia Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Lucas Alverne Freitas
authors.initials: LA
authors.lastname: de Albuquerque
authors.affiliation: Department of Neurosurgery, Santa Casa de Misericordia Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Carlos Batista Alves
authors.initials: CB
authors.lastname: de Souza Filho
authors.affiliation: Department of Neurosurgery, Santa Casa de Misericordia Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Dellaretti
authors.affiliation: Department of Neurosurgery, Santa Casa de Misericordia Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Atos Alves
authors.initials: AA
authors.lastname: de Sousa
keywords: Arteriovenous malformation; intracranial; pial arteriovenous fistula