Acquired pial arteriovenous fistula following cerebral vein thrombosis

Stroke. 1999 Nov;30(11):2487-90. doi: 10.1161/01.str.30.11.2487.


Background: We report a unique case of an acquired pial arteriovenous fistula occurring after an asymptomatic thrombosis of a superficial cerebral vein.

Case description: A cerebral angiogram performed in a 51-year-old man with subarachnoid hemorrhage revealed a 10-mm ruptured anterior communicating artery aneurysm and a thrombosed left superficial middle cerebral vein. Coil embolization of the anterior communicating aneurysm was performed. Follow-up angiography 18 months later revealed a new, asymptomatic, pial arteriovenous fistula between the previously thrombosed left superficial middle cerebral vein and a small sylvian branch of the left middle cerebral artery.

Conclusions: This case provides evidence that pial arteriovenous fistulas may develop as acquired lesions and furthermore may rarely follow cerebral vein thrombosis. Several cases of dural arteriovenous fistulas, as well as a single case of a mixed pial-dural arteriovenous fistula, occurring after dural sinus thrombosis have been reported previously. However, to our knowledge, this is the first report of an acquired pial arteriovenous fistula following a cerebral vein thrombosis.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, Ruptured / complications
  • Arteriovenous Fistula / diagnostic imaging
  • Arteriovenous Fistula / etiology*
  • Cerebral Angiography
  • Cerebral Veins / diagnostic imaging
  • Cerebral Veins / pathology*
  • Dura Mater / blood supply
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Thrombosis / complications*
  • Male
  • Meningeal Arteries / diagnostic imaging
  • Meningeal Arteries / pathology
  • Middle Aged
  • Middle Cerebral Artery / diagnostic imaging
  • Middle Cerebral Artery / pathology
  • Pia Mater / blood supply*
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / etiology