Time-resolved contrast-enhanced magnetic resonance digital subtraction angiography (MRDSA) in an infant with congenital pial arteriovenous fistula in the brain: a case report.

INTRODUCTION: Evaluation of the congenital vascular lesions of the brain requires multiple conventional intra-arterial digital subtraction angiographic examinations which have many associated risks including exposure to ionizing radiations. Magnetic resonance digital subtraction angiography is a non-invasive procedure with no related risks of radiation exposure. This technique can be of greater clinical significance in diagnosis and treatment planning of neurovascular abnormalities among children who are at far greater risk of invasive procedures like intra-arterial digital subtraction angiography. CASE REPORT: We report a congenital pial arteriovenous fistula in an infant which is a rare vascular lesion and has recently been identified as different from other vascular malformations. Magnetic resonance digital subtraction angiography provided hemodynamic information in absolute agreement with intra-arterial digital subtraction angiography indicating its significance in evaluating vascular lesions. DISCUSSION: Magnetic resonance digital subtraction angiography can be used in children in conjunction with intra-arterial digital subtraction angiography to minimize the cumulative radiation dose and multiple anesthesias.