Atraumatic vertebral arteriovenous fistula: A rare entity with two case reports.

Authors

Rabjot Rai
Joe Iwanaga
Bill Wang, Swedish Neuroscience Institute, Seattle, WA, USA
Akil P Patel, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USAFollow
Joshua Bentley, Swedish Neuroscience Institute, Seattle, WA, USAFollow
Yince Loh, Swedish Neuroscience Institute, Seattle, WA, USAFollow
Stephen Monteith, Swedish Neuroscience Institute, Seattle, Washington, USA.Follow
R Shane Tubbs, Seattle Science Foundation, Seattle, WA, USA; Swedish Neuroscience Institute, Seattle, WA, USA; Department of Anatomical Sciences, St. George's University, Grenada, West Indies

Document Type

Article

Publication Date

8-30-2018

Keywords

Abstract; Vertebral artery fistula; embolization; neurofibromatosis; spontaneous arteriovenous fistula; Adult; Arteriovenous Fistula/complications; Arteriovenous Fistula/diagnostic imaging; Arteriovenous Fistula/therapy; Diagnosis, Differential; Female; Humans; Middle Aged; Neurofibromatosis 1/complications; Vertebral Artery/abnormalities

Abstract

BACKGROUND: A vertebral artery arteriovenous fistula is rare and usually due to trauma. Atraumatic cases are quite rare. Herein, two cases and a review of other reports from the literature are presented.

CASE DESCRIPTIONS: A spontaneous vertebral-venous fistula is rare, and the two case reports discussed illustrate an underlying spontaneous etiology. The first case presented with a spontaneous fistula, while the second case was in a patient with neurofibromatosis type 1. In both cases, the fistulas were diagnosed with CTA 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 may be a predisposing factor or it may be congenital. Understanding the clinical symptoms, diagnosis, and effective management strategies are important to physicians treating patients with a vertebral artery arteriovenous fistula.

Clinical Institute

Neurosciences (Brain & Spine)

Specialty

Neurosciences