Arteriovenous fistula following thyroidectomy

An arteriovenous fistula between the superior thyroid artery and internal jugular vein is described, diagnosed 20 years after thyroidectomy. This unusual fistula produced only local symptoms, but the bruit was initially attributed to atherosclerotic obstruction of the carotid artery. Although a systolic/diastolic bruit may be generated by a tight carotid obstruction, the presence of a continuous cervical bruit should suggest an arteriovenous fistula.