TY - JOUR
T1 - Spontaneous vertebral arteriovenous fistula causing cervical myelopathy and acute ischemic strokes treated by endovascular balloon-assisted coiling and Onyx embolization
AU - John, Seby
AU - Jaffari, Neda
AU - Lu, Mei
AU - Hussain, Muhammad S.
AU - Hui, Ferdinand
PY - 2014/1
Y1 - 2014/1
N2 - Vertebral arteriovenous fistulas (VAVF) are infrequent lesions characterized by abnormal communication of the extracranial vertebral artery or one of its branches to the surrounding venous plexuses, without the presence of any intervening vessels. We describe a rare occurrence of a patient with VAVF presenting with acute ischemic stroke, encephalomalacia from multiple prior embolic events, and cervical myelopathy, which was successfully treated by coil-assisted Onyx embolization (ev3 Endovascular, Plymouth, MN, USA) with balloon for flow arrest. Our patient demonstrates that point occlusion with embolization for VAVF can be a feasible, safe, and effective treatment option for complete obliteration of the fistula, with subsequent reduction in the volume of the intra-spinal canal venous plexus. Although it is postulated that thromboembolism is less common because of redirection of flow to the venous side of the fistula, our patient also illustrates the potential for to-fro flow in such a fistula to result in embolic injury to the distal circulation.
AB - Vertebral arteriovenous fistulas (VAVF) are infrequent lesions characterized by abnormal communication of the extracranial vertebral artery or one of its branches to the surrounding venous plexuses, without the presence of any intervening vessels. We describe a rare occurrence of a patient with VAVF presenting with acute ischemic stroke, encephalomalacia from multiple prior embolic events, and cervical myelopathy, which was successfully treated by coil-assisted Onyx embolization (ev3 Endovascular, Plymouth, MN, USA) with balloon for flow arrest. Our patient demonstrates that point occlusion with embolization for VAVF can be a feasible, safe, and effective treatment option for complete obliteration of the fistula, with subsequent reduction in the volume of the intra-spinal canal venous plexus. Although it is postulated that thromboembolism is less common because of redirection of flow to the venous side of the fistula, our patient also illustrates the potential for to-fro flow in such a fistula to result in embolic injury to the distal circulation.
KW - Cervical myelopathy
KW - Coil-assisted Onyx embolization
KW - Embolic ischemic stroke
KW - Vertebral arteriovenous fistulas
UR - http://www.scopus.com/inward/record.url?scp=84890549388&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890549388&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2013.01.016
DO - 10.1016/j.jocn.2013.01.016
M3 - Article
C2 - 23972561
AN - SCOPUS:84890549388
SN - 0967-5868
VL - 21
SP - 167
EP - 170
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
IS - 1
ER -