Management of pediatric pial arteriovenous fistulas with a single connection: two illustrative cases

Pediatric arteriovenous fistulas (PAVFs) are rare, representing only 7.3-17.2% of all pediatric shunts.1 2 In a number of cases they can lead to life-threatening venous hypertension, hydrocephalus and macrocrania,3 heart failure,1 hemorrhagic stroke,4 5 seizures,3 and cognitive developmental issues.1-3 In selected circumstances, early and aggressive treatment is recommended.We present two cases of single-connection, high-flow PAVFs. Case 1 represents a mid-basilar PAVF treated through a transarterial approach, while case 2 represents a quadrigeminal cistern PAVF treated with several transarterial sessions followed by a final transvenous session. The procedures are shown in video 1 neurintsurg;17/11/1265/V1F1V1Video 1 Clinical cases demonstrating endovascular treatment of pediatric pial arteriovenous fistulas.