Spontaneous vertebral arteriovenous fistula causing cervical myelopathy and acute ischemic strokes treated by endovascular balloon-assisted coiling and Onyx embolization

Seby John, Neda Jaffari, Mei Lu, Muhammad S. Hussain, Ferdinand Hui

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)167-170
Number of pages4
JournalJournal of Clinical Neuroscience
Volume21
Issue number1
DOIs
StatePublished - Jan 2014
Externally publishedYes

Keywords

  • Cervical myelopathy
  • Coil-assisted Onyx embolization
  • Embolic ischemic stroke
  • Vertebral arteriovenous fistulas

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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