2021 Volume 43 Issue 6 Pages 561-567
We report a rare case of adult pial arteriovenous fistula (PAVF) treated with preoperative embolization and surgical excision. A 26-year-old man presented with sudden headache and vomiting. CT demonstrated a subcortical hemorrhage in the left temporal lobe. Cerebral angiograms revealed a PAVF. He was treated with endovascular embolization by n-butyl-2-cyanoacrylate (NBCA) and surgical excision. Following the sign of NBCA revealed that some fine feeding arteries were directly connected to the drainer veins and the shunts were disconnected safely and reliably. In addition, we reviewed the literatures on adult PAVF from 1979 to 2020 and discussed clinical characteristics and appropriate treatment. A review of the literature showed that 8 of 106 patients received combined endovascular and surgical treatment, of whom 75% achieved a complete obliteration and 88% had a good outcome. This case report suggests that combined endovascular and surgical treatment can be a useful treatment for PAVF.
