Pial Arteriovenous Fistula Caused by Trauma: A Case Report

• Published in: Neurologia medico-chirurgica Vol. 55; no. 11; pp. 856 - 858
• Main Authors: NOMURA, Seiji, ISHIKAWA, Osamu, TANAKA, Kentaro, OTANI, Ryohei, MIURA, Keisuke, MAEDA, Keiichiro
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 2015
• Subjects: Accidents, Traffic; Arteriovenous Fistula - diagnostic imaging; Arteriovenous Fistula - etiology; Brain Edema - complications; Brain Edema - diagnostic imaging; Case Report; Craniocerebral Trauma - complications; Craniocerebral Trauma - diagnostic imaging; edema; Headache - complications; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pia Mater - blood supply; Pia Mater - diagnostic imaging; pial arteriovenous fistula; trauma
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.cr.2015-0072

We report an extremely rare case of pial arteriovenous fistula (AVF) caused by trauma. A 61-year-old man suffered from brain contusion by a traffic accident. He was neurologically normal on admission. However, his headache gradually worsened, and partial seizures occurred thereafter. He presented with general tonic seizure 7 days after the head injury. Magnetic resonance imaging demonstrated the exacerbation of brain edema and an abnormal vein near the contusion. Subsequent angiography showed a pial AVF, which was considered to be responsible for the brain edema. After treatment of the AVF by direct surgery, the brain edema was ameliorated. We should take into consideration the formation of vascular disease in cases with unexpected worsening of edema after brain injury.