Spontaneous extracranial vertebral arteriovenous fistula with fibromuscular dysplasia

Case report

Restricted access

✓ A case of spontaneous vertebral arteriovenous fistula in association with fibromuscular dysplasia is reported. The patient presented with progressive cervical myelopathy and cervical bruit. The pathogenesis of the fistula development and the spinal cord symptoms is discussed. Symptoms subsided after obliteration of the fistula.

Article Information

Address reprint requests to: Thoralf M. Sundt, Jr., M.D., Department of Neurosurgery, Mayo Clinic/Foundation, Rochester, Minnesota 55901.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Sequential angiograms, lateral view, of the right carotid and the vertebral arteries demonstrating extensive fibromuscular dysplasia of the vertebral artery. A large vertebral arteriovenous fistula located at the C-2 vertebral level, and rapid opacification of the cervical venous plexus, can be seen. The right carotid artery shows no evidence of fibromuscular dysplasia.

  • View in gallery

    Angiography, anteroposterior and lateral views, of the left vertebral artery showing typical changes of fibromuscular dysplasia involving the entire extracranial segment of this vessel.

  • View in gallery

    Sequential angiograms, left posterior oblique views, of the right carotid and vertebral arteries again demonstrating the fibromuscular dysplasia of the vertebral artery with an arteriovenous fistula.

References

  • 1.

    Bartal ADLevy MJ: Excision of a congenital suboccipital vertebral arteriovenous fistula. Case report. J Neurosurg 37:4524561972Bartal AD Levy MJ: Excision of a congenital suboccipital vertebral arteriovenous fistula. Case report. J Neurosurg 37:452–456 1972

  • 2.

    Bergström KLodin H: Arteriovenous fistula as a complication of cerebral angiography. Report of three cases. Br J Radiol 39:2632661966Bergström K Lodin H: Arteriovenous fistula as a complication of cerebral angiography. Report of three cases. Br J Radiol 39:263–266 1966

  • 3.

    Bergquist E: Bilateral arteriovenous fistulae. A complication of vertebral angiography by direct percutaneous puncture. Two cases, one with spontaneous closure. Br J Radiol 44:5195231971Bergquist E: Bilateral arteriovenous fistulae. A complication of vertebral angiography by direct percutaneous puncture. Two cases one with spontaneous closure. Br J Radiol 44:519–523 1971

  • 4.

    Binkley FMWylie EJ: A new technique for obliteration of cerebrovascular arteriovenous fistulae. Arch Surg 106:5245271973Binkley FM Wylie EJ: A new technique for obliteration of cerebrovascular arteriovenous fistulae. Arch Surg 106:524–527 1973

  • 5.

    Bonduelle MRuscalleda JZalzal P: Dysplasie fibromusculaire avec fistule artério-veineuse de l'artère vertébrale extra-cranienne. Rev Neurol 128:2042061973Bonduelle M Ruscalleda J Zalzal P: Dysplasie fibromusculaire avec fistule artério-veineuse de l'artère vertébrale extra-cranienne. Rev Neurol 128:204–206 1973

  • 6.

    Buscaglia LCCrowhurst HD: Vertebral artery trauma. Am J Surg 138:2692721979Buscaglia LC Crowhurst HD: Vertebral artery trauma. Am J Surg 138:269–272 1979

  • 7.

    Chou SNStory JLSeljeskog Eet al: Further experience with arteriovenous fistulas of the vertebral artery in the neck. Surgery 62:7797881967Chou SN Story JL Seljeskog E et al: Further experience with arteriovenous fistulas of the vertebral artery in the neck. Surgery 62:779–788 1967

  • 8.

    Ehrlich FECarey LKitrinos NP: Congenital arteriovenous fistula between the vertebral artery and vertebral vein. Case report. J Neurosurg 29:6296301968Ehrlich FE Carey L Kitrinos NP: Congenital arteriovenous fistula between the vertebral artery and vertebral vein. Case report. J Neurosurg 29:629–630 1968

  • 9.

    Elkin DCHarris MH: Arteriovenous aneurysm of the vertebral vessels. Report of 10 cases. Ann Surg 124:9349511946Elkin DC Harris MH: Arteriovenous aneurysm of the vertebral vessels. Report of 10 cases. Ann Surg 124:934–951 1946

  • 10.

    Gooddy WSchechter MM: Spontaneous arteriovenous fistula of the vertebral artery. Br J Radiol 33:7097111960Gooddy W Schechter MM: Spontaneous arteriovenous fistula of the vertebral artery. Br J Radiol 33:709–711 1960

  • 11.

    Goodman SJHasso AKirkpatrick D: Treatment of vertebrojugular fistula by balloon occlusion. Case report. J Neurosurg 43:3623671975Goodman SJ Hasso A Kirkpatrick D: Treatment of vertebrojugular fistula by balloon occlusion. Case report. J Neurosurg 43:362–367 1975

  • 12.

    Greenberg J: Spontaneous arteriovenous malformations in the cervical area. J Neurol Neurosurg Psychiatry 33:3033091970Greenberg J: Spontaneous arteriovenous malformations in the cervical area. J Neurol Neurosurg Psychiatry 33:303–309 1970

  • 13.

    Grollman JH JrLecky JWRosch J: Miscellaneous diseases of arteries, or, all arterial lesions aren't fatty. Semin Roentgenol 5:3063211970Grollman JH Jr Lecky JW Rosch J: Miscellaneous diseases of arteries or all arterial lesions aren't fatty. Semin Roentgenol 5:306–321 1970

  • 14.

    Houser OWBaker HL JrSandok BAet al: Cephalic arterial fibromuscular dysplasia. Radiology 101:6056111971Houser OW Baker HL Jr Sandok BA et al: Cephalic arterial fibromuscular dysplasia. Radiology 101:605–611 1971

  • 15.

    Jefferson GBailey RAKerr AS: Suboccipital arteriovenous aneurysms of the vertebral artery. J Bone Joint Surg (Br) 38:1141271956Jefferson G Bailey RA Kerr AS: Suboccipital arteriovenous aneurysms of the vertebral artery. J Bone Joint Surg (Br) 38:114–127 1956

  • 16.

    Kawasaki MMiura MKagawa Met al: [A case of spontaneous extracranial vertebral A.V.M. with neurofibromatosis.] Neurol Surg 5:8778821977 (Jpn)Kawasaki M Miura M Kagawa M et al: [A case of spontaneous extracranial vertebral A.V.M. with neurofibromatosis.] Neurol Surg 5:877–882 1977 (Jpn)

  • 17.

    Lawson TLNewton TH: Congenital cervical arteriovenous malformations. Radiology 97:5655701970Lawson TL Newton TH: Congenital cervical arteriovenous malformations. Radiology 97:565–570 1970

  • 18.

    Leape LLPalacios E: Acute traumatic vertebral arteriovenous fistula. Ann Surg 174:9089101971Leape LL Palacios E: Acute traumatic vertebral arteriovenous fistula. Ann Surg 174:908–910 1971

  • 19.

    Markham JW: Spontaneous arteriovenous fistula of vertebral artery and vein. J Neurosurg 31:2202231969Markham JW: Spontaneous arteriovenous fistula of vertebral artery and vein. J Neurosurg 31:220–223 1969

  • 20.

    Moret JLasjaunias PDoyon D: Occipital approach for treatment of arteriovenous malformation of vertebral artery by balloon occlusion. Neuroradiology 17:2692731979Moret J Lasjaunias P Doyon D: Occipital approach for treatment of arteriovenous malformation of vertebral artery by balloon occlusion. Neuroradiology 17:269–273 1979

  • 21.

    Nagashima CIwasaki TKawanuma Set al: Traumatic arteriovenous fistula of the vertebral artery with spinal cord symptoms. Case report. J Neurosurg 46:6816871977Nagashima C Iwasaki T Kawanuma S et al: Traumatic arteriovenous fistula of the vertebral artery with spinal cord symptoms. Case report. J Neurosurg 46:681–687 1977

  • 22.

    Norman JASchmidt KWGrow JB: Congenital arteriovenous fistula of the cervical vertebral vessels with heart failure in an infant. J Pediatr 36:5986041950Norman JA Schmidt KW Grow JB: Congenital arteriovenous fistula of the cervical vertebral vessels with heart failure in an infant. J Pediatr 36:598–604 1950

  • 23.

    Olson RWBaker HL JrSvien HJ: Arteriovenous fistula: a complication of vertebral angiography. Report of a case. J Neurosurg 20:73751963Olson RW Baker HL Jr Svien HJ: Arteriovenous fistula: a complication of vertebral angiography. Report of a case. J Neurosurg 20:73–75 1963

  • 24.

    Reivich MHolling HERoberts Bet al: Reversal of blood flow through the vertebral artery and its effect on cerebral circulation. N Engl J Med 265:8788851961Reivich M Holling HE Roberts B et al: Reversal of blood flow through the vertebral artery and its effect on cerebral circulation. N Engl J Med 265:878–885 1961

  • 25.

    Robles J: Congenital arteriovenous malformation of the vertebral vessels in the neck. J Neurosurg 29:2062081968Robles J: Congenital arteriovenous malformation of the vertebral vessels in the neck. J Neurosurg 29:206–208 1968

  • 26.

    Russo LS Jr: Fibromuscular hyperplasia of extracranial arteries: report of a case associated with intracranial aneurysm and skeletal deformities and a brief review of literature. Mt Sinai J Med NY 40:60671973Russo LS Jr: Fibromuscular hyperplasia of extracranial arteries: report of a case associated with intracranial aneurysm and skeletal deformities and a brief review of literature. Mt Sinai J Med NY 40:60–67 1973

  • 27.

    Sangruchi VHitchcock EDonaldson AA: Postangiographic vertebral arteriovenous fistulae. Br J Surg 59:6276281972Sangruchi V Hitchcock E Donaldson AA: Postangiographic vertebral arteriovenous fistulae. Br J Surg 59:627–628 1972

  • 28.

    Sher MHMeyer NILenhardt HFet al: Arteriovenous fistula involving the vertebral artery: report of three cases. Ann Surg 163:4084131966Sher MH Meyer NI Lenhardt HF et al: Arteriovenous fistula involving the vertebral artery: report of three cases. Ann Surg 163:408–413 1966

  • 29.

    Stanley JCFry WJSeeger JFet al: Extracranial internal carotid artery and vertebral artery fibrodysplasia. Arch Surg 109:2152221974Stanley JC Fry WJ Seeger JF et al: Extracranial internal carotid artery and vertebral artery fibrodysplasia. Arch Surg 109:215–222 1974

  • 30.

    Weinberg PEFlom RA: Traumatic vertebral arteriovenous fistula. Surg Neurol 1:1621671973Weinberg PE Flom RA: Traumatic vertebral arteriovenous fistula. Surg Neurol 1:162–167 1973

TrendMD

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 44 44 5
Full Text Views 194 194 0
PDF Downloads 89 89 0
EPUB Downloads 0 0 0

PubMed

Google Scholar