Prenatal ultrasound diagnosis of cerebral arteriovenous fistula.

BACKGROUND

We describe a case of arteriovenous fistula of the middle and posterior cerebral arteries detected in a fetus.

CASE: Fetal echocardiography revealed a high-output cardiac failure. Color Doppler ultrasound demonstrated an arteriovenous fistula, localized at the middle and posterior cerebral arteries, which drained in a large venous aneurysm occupying the posterior fossa. The aneurysm caused cerebellar dislocation and temporal lobe hypoplasia. Necropsy after pregnancy termination confirmed the ultrasound findings.

CONCLUSION

This case demonstrates that malformation of a fetal cerebral artery can lead to brain hypoplasia and thus to severe mental handicap. This possibility needs to be considered in patient counseling.