Intracranial Pial Arteriovenous Fistula Presenting with

Intracranial pial arteriovenous fistula (AVF) is a rare cerebrovascular mal-formation, which has a single or multiple arterial connections to a single venous channel without intervening nidus, and is different from arterio-venous malformation (AVM). We report on a case of a surgically treated pial AVF. A 15-year-old girl with an altered mental state was brought to our hospital. Computed tomography (CT) showed a subcortical hematoma of approximately 24 ml in her right temporal lobe. Cerebral angiography showed an AVF supplied by the right middle cerebral artery with early drainage into the Sylvian vein and the vein of Labbe. She underwent surgical treatment with feeding artery obliteration using a clip and hema-toma removal. The patient was discharged without neurologic deficits. Despite the rarity of pial AVF, for correct diagnosis and treatment, neuro-surgeons should recognize this condition. Pial AVF can be managed sim-ply by disconnection of the shunt by surgery or endovascular treatment, and a good result can be achieved. J Cerebrovasc Endovasc Neurosurg