Expect the unexpected: a case of spontaneous thrombosis of a pial arteriovenous fistula in a preterm newborn with review of the literature

Childs Nerv Syst. 2023 Mar;39(3):793-799. doi: 10.1007/s00381-022-05652-y. Epub 2022 Sep 26.

Abstract

Introduction: Pial arteriovenous fistulas (pAVF) are rare vascular malformations, especially in children and newborns. In neonates, the most common symptom is congestive heart failure.

Case presentation: We report a case of an asymptomatic preterm newborn incidentally diagnosed with pAVF during a routine cranial ultrasound (cUS) on the third day of life. Cerebral magnetic resonance (MRI) confirmed the diagnosis. A wait-and-see approach was chosen by the multidisciplinary team. The cUS and the MRI on day 14 of life showed the spontaneous resolution of the lesion.

Conclusions: This case underlines the challenges in identifying pAVF in the first weeks of life and demonstrates a possible positive outcome for affected neonates.

Keywords: Newborn; Pial arteriovenous fistula; Preterm; Thrombosis.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Arteriovenous Fistula* / complications
  • Arteriovenous Fistula* / diagnostic imaging
  • Child
  • Humans
  • Infant, Newborn
  • Intracranial Arteriovenous Malformations* / complications
  • Intracranial Arteriovenous Malformations* / diagnostic imaging
  • Magnetic Resonance Imaging
  • Pia Mater / diagnostic imaging
  • Thrombosis*