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Complex arteriovenous fistula of the brain in an infant. Case report

G Talamonti1, P P Versari, G D'Aliberti

  • 1Department of Neurosurgery, Niguarda Ca' Granda Hospital, Milan, Italy.

Insights

A rare complex cerebral arteriovenous fistula in an infant was successfully treated with direct surgery. This case highlights effective management for increased intracranial pressure caused by direct intracerebral arteriovenous shunts.

Area of Science:

  • Pediatric Neurology
  • Vascular Neurosurgery
  • Neuroradiology

Background:

  • Cerebral arteriovenous fistulas (CAFs) are rare vascular malformations.
  • Complex CAFs in infants present unique diagnostic and therapeutic challenges.
  • Increased intracranial pressure (ICP) can be a presenting symptom.

Observation:

  • An 8-month-old boy presented with symptoms of elevated ICP.
  • Neuroradiological evaluation revealed a direct intracerebral arteriovenous shunt.
  • Significant venous engorgement was noted, but no hemorrhage.

Findings:

  • The patient underwent direct surgical intervention for the complex CAF.
  • Successful clinical and radioanatomical cure was achieved post-surgery.
  • Angiographic and pathophysiologic features were analyzed.

Implications:

  • Direct surgical treatment can be effective for complex pediatric CAFs causing ICP.
  • Understanding the pathophysiology is crucial for therapeutic decision-making.
  • This case contributes to the literature on rare pediatric cerebrovascular disorders.

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