Background: Pial single-channel arteriovenous (AV) fistulae are usually cured by interrupting only the feeding arteries identified in cerebral angiography.
Case description: A 27-year-old woman presented after 3 complex partial seizures due to a pial single-channel AV fistula with the varix located in the right temporal lobe. When all feeding arteries identified by preoperative cerebral angiography were temporarily occluded, varix blood flow was confirmed with Doppler ultrasonography. Many small feeding arteries were identified, and the varix was dissected and removed. The postoperative course was uneventful and postoperative cerebral angiography revealed no abnormal vascular lesions.
Conclusion: Pial single-channel AV fistulae are not always cured by interrupting only the feeding arteries identified in cerebral angiography and might require varix removal.