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Spontaneous vertebral arteriovenous fistula--case report
1Department of Neurosurgery, Kobe City General Hospital.
Neurologia Medico-Chirurgica
|June 15, 2000
Summary
A rare vertebral arteriovenous fistula caused arm radiculopathy and tinnitus. Successful coil embolization resolved symptoms, highlighting chiropractic manipulation as a potential cause.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Spontaneous vertebral arteriovenous fistulas are rare vascular malformations.
- Vertebral artery dissection can be linked to chiropractic manipulation.
- Radiculopathy can present with symptoms like arm pain and neurological deficits.
Observation:
- A 57-year-old male presented with right arm radiculopathy, pulsating tinnitus, and neck bruit.
- Past history revealed vertebrobasilar infarction following chiropractic manipulation.
- Angiography confirmed a direct fistula between the right vertebral artery and epidural veins at C-1.
Findings:
- The fistula caused mechanical compression of nerve roots by engorged epidural veins.
- Successful coil embolization of the fistula led to rapid symptom improvement.
- Chiropractic-induced vertebral artery dissection is the suspected etiology.
Implications:
- This case underscores the importance of considering iatrogenic causes for vertebral arteriovenous fistulas.
- Endovascular treatment offers a minimally invasive option for managing such rare conditions.
- Prompt diagnosis and intervention can prevent serious neurological complications.