TY - JOUR AU - de Aguiar, G. B.; Conti, M.L. M.; Veiga, J.C. E.; Jory, M. TI - Giant Intracranial Pial Arteriovenous Fistula Treated by Endovascular Intervention SN - 0946-7211 SN - 1439-2291 PY - 2011 JO - Minim Invasive Neurosurg JF - min - Minimally Invasive Neurosurgery LA - EN VL - 54 IS - 05/06 SP - 247 EP - 249 DA - 2012/01/25 KW - arteriovenous malformation KW - subarachnoid hemorrhage KW - vascular malformation KW - endovascular treatment AB - Arteriovenous fistulas (AVF) are rare vascular lesions of the brain that differ from arteriovenous malformations as they present a direct connection between artery and vein, without interposition of the nidus. They are fed by one or more arterial branches, with a single draining vein. Clinically they can be revealed through cerebral hemorrhage, convulsive crisis, neurological deficit, heart failure in neonates and infants, headache, bruit, or intracranial hypertension symptoms.A 30-year-old patient was found unconscious on a public street, presenting a generalized tonic-clonic convulsive crisis. At admission, she presented with ocular proptosis, conjunctival hyperemia and bilateral jugular turgescence. The cranial computed tomography showed diffuse subarachnoid hemorrhage, and the cerebral angiography evidenced a giant intracranial pial AVF with high flow supplied by 2 branches of the left anterior cerebral artery.The patient underwent endovascular treatment in 2 sessions, using a mixture of histoacryl and lipiodol for complete occlusion of the lesion. She was discharged after a month, alert, devoid of motor deficit, and the ocular proptosis and the conjunctival hyperemia had decreased.AVFs are rare vascular lesions that require prompt treatment. The endovascular treatment must be considered, especially when the lesions are deep and the risks of neurological deficit associated with the surgery are high. Endoscopic intervention represents an effective and safe option for the treatment of this type of lesion. PB - © Georg Thieme Verlag KG DO - 10.1055/s-0031-1283127 UR - http://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0031-1283127 ER -