Stroke Etiology Discussion & AV fistula vs. AVM Case

The tenth International Pediatric Stroke Challenging Case Conference took place on:

Tuesday, July 17th, 2022 at 10am PST/ 12pm CST/ 1pm EST/ 7pm GMT + 2.

The recording and chat discussion from the 10th Challenging Case Conference
can be found in the members’ only area.


Suman Das, MD

Suman Das, MD a pediatric neurologist at Bangur Institute of Neurosciences in Kolkata, India presented a 4.5 months old afebrile infant, after multiple episodes of vomiting over 4 days, developed multiple episodes of GTCS and CT scan showed cerebral oedema (R>L), mild bilateral subdural effusion, and tentorial SDH, while contrast MRI 10 days later showed increased in SDH, gyrfalcon pattern enhancements in right cerebral hemisphere, patchy DWI restrictions in both anterior and posterior circulations. MR angiograph showed less robust right MCA compared to the left, contrast venogram was normal, with normal metabolic parameters. Dr. Das was seeking advice on what could be the etiology of the diffuse asymmetrical cerebral edema progressing to bilateral subdural effusion and then to cerebral infarcts in a child without any risk factors or history of trauma.

Rabia Qaiser, MD, FAANS

Rabia Qaiser, MD, FAANS, a pediatric neurosurgeon, at the Riley Hospital for Children at Indiana University Health in Indianapolis, United States, presented a case about 14 yr old M presented with new onset seizure (left facial tingling/numbness followed by GTC). Prior to that had been having an episode of left sided numbness and aphasia. Unremarkable PMHx/PSHx/FHx. Dr. Qaiser was seeking advice on whether this was an AV fistula or AVM diagnosis.


Heather Fullerton, MD, MAS

UCSF Benioff Children’s Hospital

Nicholas Stence, MD

Children’s Hospital of Colorado

Alfred See, MD

Neurosurgeon & Neurointerventionalist
Boston Children’s Hospital