Congestive Heart Failure From Intracranial Arteriovenous Fistula in Infancy

The clinical recognition of an intracranial arteriovenous fistula in a newborn infant depends on finding good peripheral pulses, a hyperdynamic cardiac impulse, cardiomegaly, and a cranial bruit. Dilated scalp veins and visible vascular malformations over the head will point toward the diagnosis. Cardiac catheterization can be diagnostic through recognition of a wide pulse pressure in combination with high oxygen saturations in the jugular veins and the right heart chambers. Cerebral angiography provides required anatomic detail. Surgical clipping of the feeding arteries may be helpful and even curative.