Acute Formation of a Blunt Trauma-induced Vertebral Artery Arteriovenous Fistula Treated with Endovascular Occlusion of Vertebral Artery

Young, Michael; Johnson, Ryan; Gordhan, Ajeet

doi:10.7759/cureus.5801

Cited by 3 publications

(8 citation statements)

References 15 publications

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“…AVF in the vertebral artery usually occurs iatrogenically. [ 6 ] In AVF, a high flow shunt is formed from the artery to the vein. Thus, dilation is observed in the vein after arterialization of the vein.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to the two previously reported cases of AVF that developed after BCT, the lesion was at the C1-2 vertebrae level. [ 5 , 6 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 ] It has been reported that AVF in a vertebral artery typically develops iatrogenically due to percutaneous nerve blog applications and radiation therapy after vascular applications, such as central venous catheterization and diagnostic cerebral angiography. [ 6 ] In addition, cases of AVF can occur after penetrating neck injury or cervical spine surgery. [ 6 ] A relationship between blunt trauma and AVF is rarer; only two cases have been reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…[ 6 ] In addition, cases of AVF can occur after penetrating neck injury or cervical spine surgery. [ 6 ] A relationship between blunt trauma and AVF is rarer; only two cases have been reported in the literature. [ 5 , 6 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 6 ] A relationship between blunt trauma and AVF is rarer; only two cases have been reported in the literature. [ 5 , 6 ]…”

Section: Introductionmentioning

confidence: 99%

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Vertebral arteriovenous fistule due to blunt neck trauma: case report

Karakoyun¹

2020

Ulus Travma Acil Cerrahi Derg

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The arteriovenous fistulas (AVFs) of the vertebral artery are usually caused by iatrogenic and penetrating traumas. Vertebral AVF is rarely seen after blunt cervical trauma. A 65-year-old male patient applied to the emergency clinic due to falling from a height of about 3 m. In his neurological examination, he had weakness in the left upper limb and tinnitus in the left ear. The cervical computed tomography examination showed a Hangman’s fracture, a C3 vertebra corpus compression fracture, and a C1 anterior arch fracture. There was a separation on the C1-2 transverse foramen due to the fracture, and there was a fracture in the left C3-4 transverse foramen. In cervical magnetic resonance imaging (MRI), the presence of a contusion in the spinal cord at the C2 corpus level was observed. Through an MRI angiography examination of the vertebral artery, it was determined that the left vertebral artery had developed an AVF at the V2-3 segment level. Stabilization surgery was performed with a posterior approach for unstable vertebrae. Then, vertebral AVF was then closed endovascularly using a stent coil. Improvement in neurological deficit was seen after surgery and endovascular treatment. There were no complications related to the procedure. Transverse foramen should be carefully evaluated, especially in the upper cervical trauma. Vertebral artery imaging should be performed before instability surgery in the presence of a separation in the fracture line to determine whether the damage to the vertebral artery is iatrogenic.

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Section: Discussionmentioning

confidence: 99%

“…Similar to the two previously reported cases of AVF that developed after BCT, the lesion was at the C1-2 vertebrae level. [ 5 , 6 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…[ 6 ] A relationship between blunt trauma and AVF is rarer; only two cases have been reported in the literature. [ 5 , 6 ]…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Vertebral arteriovenous fistule due to blunt neck trauma: case report

Karakoyun¹

2020

Ulus Travma Acil Cerrahi Derg

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Mild trauma causing cervical fracture through transverse foramen leading to a vertebral arteriovenous fistula

2021

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Vertebral arteriovenous fistula (vAVF) is an uncommon vascular disease defined as abnormal connections between the vertebral artery or its branches extracranially with nearby venous structures. This case report outlines the case of a man in his late 70s presenting with C1–C3 fractures after a mild trauma falling down a small staircase. CT angiogram (CTA) gave suspicion of vertebral artery dissection and pseudoaneurysm; however, digital subtraction angiography revealed a fracture-induced vAVF successfully treated endovascularly with coils. In conclusion, cervical fractures involving the transverse foramen regardless of trauma mechanism should result in a CTA. Endovascular treatment with ipsilateral vertebral artery closure is preferred due to its feasibility and safety.

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Late-developing posttraumatic dural arteriovenous fistula of the vertebral artery: illustrative case

Schenck,

Fodor,

Wagemans

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND A dural arteriovenous fistula (dAVF) involving the vertebral artery (VA) is a rare vascular pathology that can result from damage to the VA, most frequently following cervical spine trauma. In most traumatic cases, the dAVF develops and manifests shortly after trauma. OBSERVATIONS A patient was admitted after a fall from the stairs causing neck pain. Computed tomography of the cervical spine revealed a Hangman’s fracture, and angiography showed a left VA dissection. The patient was treated with a cervical brace and clopidogrel. Three weeks after trauma, the patient was admitted because of bilateral leg ataxia, dizziness, and neck pain. Repeat imaging revealed increased displacement of the cervical fracture and a dAVF from the left VA with retrograde filling of the dAVF from the right VA. Embolization of the dAVF using coils proximally and distally to the dAVF was performed prior to placing a halo brace. At 6 months, all symptoms had disappeared and union of the cervical spine fracture had occurred. LESSONS This case report emphasizes the need for follow-up angiography after traumatic VA injury resulting from cervical spine fracture and underlines important treatment considerations for successful obliteration of a dAVF of the VA.

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Acute Formation of a Blunt Trauma-induced Vertebral Artery Arteriovenous Fistula Treated with Endovascular Occlusion of Vertebral Artery

Cited by 3 publications

References 15 publications

Vertebral arteriovenous fistule due to blunt neck trauma: case report

Vertebral arteriovenous fistule due to blunt neck trauma: case report

Mild trauma causing cervical fracture through transverse foramen leading to a vertebral arteriovenous fistula

Late-developing posttraumatic dural arteriovenous fistula of the vertebral artery: illustrative case

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