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Abstract - Case Report
| J Cerebrovasc Endovasc Neurosurg. 2024 26(1): 79-84 ¨Ï The Journal of Cerebrovascular and Endovascular Neurosurgery |
 
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| Spontaneous occlusion of a pial arteriovenous fistula after angiography: The role of iodinated contrast media |
| Seby John1, Tanmoy Kumar Maiti1, Praveen Kesav1, Ashna Arif2, Syed Irteza Hussain1 |
| 1Department of Neurology and Neurointerventional Surgery, Neurological Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates 2School of Medicine, Queen¡¯s University, Belfast, Ireland |
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| Intracranial non-galenic pial arteriovenous fistula (PAVF) is an extremely rare vascular malformation, where one or more pial arteries feeds directly into a cortical vein without any intervening nidus. Though occasionally they can be asymptomatic, neurological symptoms such as headache, seizure, or focal neurological deficit are more common presenting features. Life threatening or fatal hemorrhage is not uncommon, hence needed to be treated more often than not. Spontaneous occlusion of PAVF is reported only four times before. We report a 49-year-old gentleman, who was diagnosed to have a PAVF, possibly secondary to trauma. He presented 5 months and 22 days from initial digital subtraction angiography (DSA) for treatment, and follow-up angiogram showed complete obliteration. He denied any significant event, medication or alternate treatment during this period. His clinical symptoms were stable as well. We postulate iodinated contrast medium induced vasculopathy as a possible cause, which has been described for other vascular pathologies, but never for PAVF. |
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| Key words : Central nervous system vascular malformations, R04;Pial arteriovenous fistula, Spontaneous occlusion, Contrast agents, Iodine |
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