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Endovascular Treatment of Symptomatic High-Flow Vertebral Arteriovenous Fistula as a Complication after C1 Screw Insertion
Journal of Korean Neurosurgical Society ; : 348-352, 2014.
Article in English | WPRIM | ID: wpr-13558
ABSTRACT
High-flow vertebral arteriovenous fistulas (VAVF) are rare complications of cervical spine surgery and characterized by iatrogenic direct-communication of the extracranial vertebral artery (VA) to the surrounding venous plexuses. The authors describe two patients with VAVF presenting with ischemic presentation after C1 pedicle screw insertion for a treatment of C2 fracture and nontraumatic atlatoaxial subluxation. The first patient presented with drowsy consciousness with blurred vision. The diffusion MRI showed an acute infarction on bilateral cerebellum and occipital lobes. The second patient presented with pulsatile tinnitus, dysarthria and a subjective weakness and numbness of extremities. In both cases, digital subtraction angiography demonstrated high-flow direct VAVFs adjacent to C1 screws. The VAVF of the second case occurred near the left posterior inferior cerebellar artery originated from the persistent first intersegmental artery of the left VA. Both cases were successfully treated by complete occlusion of the fistulous portion and the involved segment of the left VA using endovascular coil embolization. The authors reviewed the VAVFs after the upper-cervical spine surgery including C1 screw insertion and the feasibility with the attention notes of its endovascular treatment.
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Arteries / Spine / Tinnitus / Vertebral Artery / Angiography, Digital Subtraction / Cerebellum / Arteriovenous Fistula / Consciousness / Diffusion Magnetic Resonance Imaging / Dysarthria Type of study: Diagnostic study Limits: Humans Language: English Journal: Journal of Korean Neurosurgical Society Year: 2014 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Arteries / Spine / Tinnitus / Vertebral Artery / Angiography, Digital Subtraction / Cerebellum / Arteriovenous Fistula / Consciousness / Diffusion Magnetic Resonance Imaging / Dysarthria Type of study: Diagnostic study Limits: Humans Language: English Journal: Journal of Korean Neurosurgical Society Year: 2014 Type: Article