en Case report <p style="text-align: justify;">Background and Importance: Intracranial pial arteriovenous fistula is a recently described matter as a rare&nbsp;vascular malformation occurring in children. It is usually located in the subpial space in the intracranial&nbsp;cavity with a high-flow shunt.<br> Case Presentation: Authors report on a 2-year-old child with intracranial pial arteriovenous fistula and&nbsp;progressive enlargement of head and seizures mimicking progressive obstructive hydrocephalus for eight&nbsp;months. Cranial computed tomography showed a hyperdense midline vein of Galen and enlarged straight&nbsp;sinus associated with obstructive hydrocephalus. Presence of an aneurysm of the vein of Galen was suspected.<br> Conclusion: Authors believe that cranial screening with computed tomography for suspected early diagnosis&nbsp;is of high importance.</p> Pial, Arteriovenous, Fistula, Galen, Aneurysm, Pediatric, Embolization, Hydrocephalus 67 63 http://irjns.org/browse.php?a_code=A-10-175-1&slc_lang=en&sid=1 Jorge Valderrama diplomadoneurotrauma@gmail.com 10031947532846002248 10031947532846002248 Yes National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico Ricardo Garcia nzabaleta@aol.com 10031947532846002249 10031947532846002249 No National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico Guru Satyarthee drguruduttaaiims@gmail.com 10031947532846002250 10031947532846002250 No Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India Willem Calderon willem.calderon@hotmail.com 10031947532846002251 10031947532846002251 No Hospital General Dr.Manuel Gea González, Mexico City, Mexico Samer Hoz 10031947532846002252 10031947532846002252 No Neurosurgeon, Neurosurgery Teaching Hospital, Baghdad, Iraq Alexis Narvaez-Rojas 10031947532846002253 10031947532846002253 No The National Autonomous University of Nicaragua, Managua, Nicaragua Luis Moscote 10031947532846002254 10031947532846002254 No Department of Neurosurgery, University of Cartagena, Colombia. Telephone: +57 5 6646183. rafaelmoscote21@gmail.com