Pial arteriovenous fistula

Last revised by Francis Deng on 8 Apr 2021

Pial arteriovenous fistulae (pAVF) are rare vascular malformations that usually consist of a single dilated pial artery connecting directly to an enlarged cortical draining vein.


pAVFs are distinct from pial arteriovenous malformations because they do not have a nidus and distinct from dural arteriovenous fistula (dAVF) because they arise from a pial artery rather than a dural artery 1.


These are rare entities accounting for 1.6% of all intracranial vascular malformations 2.

Radiographic features

Unlike dAVFs, 80% of pAVFs are supratentorial and typically lie adjacent to the ventricular ependyma or just beneath the brain surface.

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