Effectiveness of intraoperative indocyanine green videoangiography in direct surgical treatment of pediatric intracranial pial arteriovenous fistula.

Abstract

Intracranial pial arteriovenous fistulas (AVFs) are rare cerebrovascular lesions. The authors report a rare case of pediatric pial AVF treated by direct disconnection with the aid of indocyanine green (ICG) videoangiography. A 3-year-old girl presented with developmental problems. Magnetic resonance imaging revealed brain atrophy and an anomalous left temporal vascular mass. Angiography showed a high-flow pial AVF in the early arterial phase fed by the M1 portion of the left middle cerebral artery and draining into the superficial sylvian vein and the vein of Trolard with a large varix. Given that her fistula was located in a superficial region that was easily accessible by craniotomy, the authors successfully disconnected her pial AVF by direct surgery aided by ICG videoangiography, which clearly confirmed the shunting point. In this report, the authors discuss the existing literature and compare the relative merits of endovascular versus surgical options for the treatment of pial AVF.

• Authors: Tadashi Sugimoto, Young-Su Park, Ichiro Nakagawa, Fumihiko Nishimura, Yasushi Motoyama, Hiroyuki Nakase
• Journal: Journal of neurosurgery. Pediatrics (J Neurosurg Pediatr) Vol. 15 Issue 1 Pg. 55-9 (Jan 2015) ISSN: 1933-0715 [Electronic] United States
• PMID: 25343732 (Publication Type: Case Reports, Journal Article)

Chemical References

• Coloring Agents
• Indocyanine Green

Topics

• Arteriovenous Fistula (diagnostic imaging, surgery)
• Atrophy (diagnosis)
• Brain (pathology)
• Cerebral Angiography (methods)
• Cerebral Veins (surgery)
• Coloring Agents
• Craniotomy (methods)
• Female
• Frontal Lobe (surgery)
• Humans
• Imaging, Three-Dimensional
• Indocyanine Green
• Infant
• Intracranial Arteriovenous Malformations (diagnostic imaging, surgery)
• Intraoperative Period
• Magnetic Resonance Imaging
• Middle Cerebral Artery (surgery)
• Pia Mater (pathology)
• Temporal Lobe (blood supply, surgery)
• Tomography, X-Ray Computed
• Varicose Veins (diagnosis, surgery)
• Video Recording