Fístula arteriovenosa pial [Neurocirugía Contemporánea ISSN 1988-2661]

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====== Fístula arteriovenosa pial ======

Es una lesion vascular cerebral, reconocida como anomalía vascular diferente dentro de la [[malformacion arteriovenosa cerebral]].

Difieren de las malformaciones arteriovenosas, que no tienen nido, y se componen de uno o más arterias nutricias con una sola vena de drenaje. 

Muchos de ellos tienen asociado una variz venosa o aneurisma venoso gigante. 

Se diferencian de las [[fistula_arteriovenosa_dural|fístulas arteriovenosas]] durales en que las arterias aferentes son piales y no se encuentra englobadas dentro de la duramadre.

**Epidemiología**

Constituyen el 1,6% de las [[malformacion_vascular|malformaciones vasculares cerebrales]].

Hasta un 25% presentan asociación con la [[telangiectasia_capilar|telangiectasia hemorrágica hereditaria]].

En una revisión de 7 pacientes pediátricos, la edad media fue de 4,2 años. La presentación clínica más frecuente fue la insuficiencia cardiaca.

Dos pacientes tenían una mutación del gen RASA1, asociado a un síndrome vascular hereditario.

El tratamiento endovascular combinado con la cirugía fué el tratamiento más frecuentemente empleado (Walcott y col., 2012).

**Localización**

Las intracraneales son más frecuentes que las espinales.

**Bibliografía**

Walcott, Brian P, Edward R Smith, R Michael Scott, and Darren B Orbach. 2012. “Pial arteriovenous fistulae in pediatric patients: associated syndromes and treatment outcome.” Journal of Neurointerventional Surgery (January 2). doi:10.1136/neurintsurg-2011-010168. http://www.ncbi.nlm.nih.gov/pubmed/22213836.


**Bibliografía recomendada**

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