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Pial AV Fistula
Anne G. Osborn, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Pial arteriovenous fistula (pAVF)
            • Definitions

              • Pial vascular malformation with direct arteriovenous (AV) shunting
                • 1 or more pial (cortical) arteries connects to single venous channel
                • No intervening capillary bed or nidus
              • Rare (1-2% of all intracranial AV malformations)

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Angiographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Natural History & Prognosis

                                • Treatment

                                  Selected References

                                  1. Kalra N et al: Surgical disconnection of a residual paediatric pial arterio-venous fistula following partial embolisation : A case study. World Neurosurg. ePub, 2020
                                  2. Lv X et al: Pediatric intracranial arteriovenous shunts: advances in diagnosis and treatment. Eur J Paediatr Neurol. 138: 227-30, 2020
                                  3. Wang S et al: Trigeminal neuralgia associated with cerebellar pial arteriovenous fistula: a case report. Medicine (Baltimore). 99(3):e18873, 2020
                                  4. Lin TC et al: De novo formation of pial arteriovenous fistulas: systematic review of acquired lesions and their clinical differences compared with primary lesions. World Neurosurg. 128:e276-82, 2019
                                  5. Goel A et al: Pial arteriovenous fistula: a brief review and report of 14 surgically treated cases. World Neurosurg. 110:e873-81, 2018
                                  6. Griffin AS et al: Onyx embolization of a pial AV fistula with a giant venous varix using a flow-directed Scepter balloon catheter: Technical note. Interv Neuroradiol. 24(6):702-5, 2018
                                  7. Yu J et al: Intracranial non-galenic pial arteriovenous fistula: a review of the literature. Interv Neuroradiol. 22(5):557-68, 2016
                                  8. Jouibari MF et al: Pial arteriovenous fistula with giant varices: report of two cases with good surgical outcome. J Cerebrovasc Endovasc Neurosurg. 16(2):98-103, 2014
                                  9. Jabbour P et al: Endovascular treatment of cerebral dural and pial arteriovenous fistulas. Neuroimaging Clin N Am. 23(4):625-36, 2013
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Pathology

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Abbreviations

                                              • Pial arteriovenous fistula (pAVF)
                                            • Definitions

                                              • Pial vascular malformation with direct arteriovenous (AV) shunting
                                                • 1 or more pial (cortical) arteries connects to single venous channel
                                                • No intervening capillary bed or nidus
                                              • Rare (1-2% of all intracranial AV malformations)

                                            IMAGING

                                            • General Features

                                              • CT Findings

                                                • MR Findings

                                                  • Angiographic Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  Selected References

                                                                  1. Kalra N et al: Surgical disconnection of a residual paediatric pial arterio-venous fistula following partial embolisation : A case study. World Neurosurg. ePub, 2020
                                                                  2. Lv X et al: Pediatric intracranial arteriovenous shunts: advances in diagnosis and treatment. Eur J Paediatr Neurol. 138: 227-30, 2020
                                                                  3. Wang S et al: Trigeminal neuralgia associated with cerebellar pial arteriovenous fistula: a case report. Medicine (Baltimore). 99(3):e18873, 2020
                                                                  4. Lin TC et al: De novo formation of pial arteriovenous fistulas: systematic review of acquired lesions and their clinical differences compared with primary lesions. World Neurosurg. 128:e276-82, 2019
                                                                  5. Goel A et al: Pial arteriovenous fistula: a brief review and report of 14 surgically treated cases. World Neurosurg. 110:e873-81, 2018
                                                                  6. Griffin AS et al: Onyx embolization of a pial AV fistula with a giant venous varix using a flow-directed Scepter balloon catheter: Technical note. Interv Neuroradiol. 24(6):702-5, 2018
                                                                  7. Yu J et al: Intracranial non-galenic pial arteriovenous fistula: a review of the literature. Interv Neuroradiol. 22(5):557-68, 2016
                                                                  8. Jouibari MF et al: Pial arteriovenous fistula with giant varices: report of two cases with good surgical outcome. J Cerebrovasc Endovasc Neurosurg. 16(2):98-103, 2014
                                                                  9. Jabbour P et al: Endovascular treatment of cerebral dural and pial arteriovenous fistulas. Neuroimaging Clin N Am. 23(4):625-36, 2013