Abstract
Intracranial pial arteriovenous fistula (AVF) is a rare cerebrovascular lesion, Pial AVFs presenting as bilateral thalamic hyperintensity is extremely rare. To the best of our knowledge, only a single case has been reported in the literature. A 57-year-old male patient presented at our institution with a decreased level of consciousness and generalized weakness. An occipital arteriovenous malformation was shown on imaging. Endovascular embolization failed. Management of the fistula was achieved using a clipping method. We report on this rare case and provide a review of the literature.