title: Endovascular embolization of pial arteriovenous fistula fed from P1 segment of posterior cerebral artery in 12 years old girl: case report and review of literature.
abstract: OBJECTIVE
  Intracranial pial arteriovenous fistulas (PAVFs) are rare vascular lesions with peculiar epidemiological, morphological, and pathophysiological characteristics. Since there is no nidus, PAVF treatment has been performed by direct disconnection of the arteriovenous communication via a surgical, endovascular, or a combined approach. We aim to outline the relevant variables to consider in planning an endovascular treatment strategy.
  
  
  METHODS
  We present a case of a 12 year old girl with a single feeder PAVF originating from the first segment (P1) of the left posterior cerebral artery with a varicose venous drainage into the right cavernous sinus.
  
  
  RESULTS
  We report the successful endovascular exclusion of the fistula with the release of a total of 27 detachable platinum coils with no complications at follow-up. Treatment strategy and nuances are discussed along with a review of the literature.
  
  
  CONCLUSIONS
  Morphology, age, embolization strategies, and materials are the different variables to be analyzed in the endovascular treatment of such lesions.
authors.affiliation: Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Italy danielebongetta@hotmail.com.
authors.forename: Daniele
authors.initials: D
authors.lastname: Bongetta
authors.affiliation: Radiodiagnostic and Neuroradiological Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
authors.forename: Elvis
authors.initials: E
authors.lastname: Lafe
authors.affiliation: Neurosurgery Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
authors.forename: Raffaelino
authors.initials: R
authors.lastname: Pugliese
authors.affiliation: Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cattalani
authors.affiliation: Neurosurgery Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gaetani
authors.affiliation: Radiodiagnostic and Neuroradiological Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
authors.forename: Federico Zappoli
authors.initials: FZ
authors.lastname: Thyrion
mesh_terms: D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000601:surgery*; D002533:Cerebral Angiography; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D010841:Pia Mater / Q000098:blood supply*; D020769:Posterior Cerebral Artery / Q000002:abnormalities*
keywords: endovascular embolization; pial arteriovenous fistula