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

Abstract

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.

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

“…4 To improve our understanding of this rare entity, we reviewed and summarized the literature on traumatic dAVFs of the VA (Table 1). [5][6][7][8][9][10][11][12][13][14][15][16] Fistulas involving the VA can be asymptomatic due to paired vessel perfusion compensation (Table 1; cases by Andersen et al 14 and Sarath Chander et al 15 ) or present with symptoms of vertebrobasilar insufficiency, including tinnitus (case by Karakoyun et al 16 ), vertigo, visual changes, ataxia, or lowered level of consciousness. 1,12,17 Enlarged or aneurysmatic fistulas with vascular steal manifest as radiculopathy, neck and occipital pain, or myelopathy (Table 1; cases by Avellanosa et al 5 and Karakoyun et al 16 ).…”