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Pial AV Fistula Embolization

Intracranial pial arteriovenous fistula (AVF) is a rare cerebrovascular lesion that has only recently been recognized as a distinct pathological entity. Pial AVF accounts for 1.6% of all intracranial vascular malformations. Intracranial pial AVFs have a single or multiple arterial connections to a single venous channel. They differ from brain arteriovenous malformations in that they lack a true nidus. They differ from dural AVFs in that they derive their arterial supply from pial or cortical arteries and are not located within the dura mater. Because pial AVF has a poor natural history, the clinical suspicion of pial AVF, followed by prompt appropriate treatment is important.