Single hole cerebral arteriovenous fistula between the anterior choroidal artery and the basal vein of Rosenthal in a child.

PURPOSE: The purpose of this study was to show the first reported case of a cerebral arteriovenous fistula (CAVF) from the anterior choroidal artery (AChoA) to the basal vein of Rosenthal in a Child.

CASE REPORT: A 4-month-old male infant with no previous history presented a left thalamic intraparenchymal hemorrhage with secondary intraventricular spread and hydrocephalus. An external ventricular drainage was placed, and a digital subtracted angiography showed a left single hole CAVF. The left AChoA was the single arterial feeder directly connected to the ipsilateral basal vein of Rosenthal. After stabilization and good recovery, he was transferred to our institution for endovascular treatment. He was embolized using the arterial feeder with four Guglielmi detachable coils that produced complete exclusion of the fistula. The patient was discharged 10 days after the procedure without new neurological deficit.

CONCLUSIONS

CAVFs are exceptional, with an incidence between 4.7% and 17% of all brain AVMs in large reported series. They can arise from any artery of the brain with a great dominance at the supratentorial location. This is the first reported case of a CAVF from the AChoA draining to the basal vein of Rosenthal.