Atraumatic Vertebral Arteriovenous Fistula: A Rare Entity with Two Case Reports.

World Neurosurg. 2018 Dec;120:66-71. doi: 10.1016/j.wneu.2018.08.160. Epub 2018 Aug 30.

Rai R, Iwanaga J, Wang B, Patel A, Bentley J, Loh Y, Monteith S, Tubbs RS.

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Abstract

BACKGROUND:

A vertebral artery arteriovenous fistula is rare and usually due to trauma. Atraumatic cases are quite rare. We reported 2 cases and a review of other reported studies.

CASE DESCRIPTION:

A spontaneous vertebral-venous fistula is rare, and the 2 cases presented illustrate an underlying spontaneous etiology. The first patient presented with a spontaneous fistula, and the second case occurred in a patient with neurofibromatosis type 1. In both cases, the fistulas were diagnosed using computed tomography angiography and treated with occlusion via coil embolization.

CONCLUSIONS:

Vascular changes are known in patients with neurofibromatosis. A proposed pathogenesis of fistula is that the fragility and defective nature of the arterial wall could be a predisposing factor or it might be congenital. Understanding the clinical symptoms, diagnosis, and effective management strategies are important for physicians treating patients with a vertebral artery arteriovenous fistula.

Copyright © 2018. Published by Elsevier Inc.

KEYWORDS:

Fistula embolization; Neurofibromatosis; Spontaneous arteriovenous fistula; Vertebral artery