Mild trauma causing cervical fracture through transverse foramen leading to a vertebral arteriovenous fistula. Issue 6 (30th June 2021)

• Record Type: Journal Article
• Authors: Andersen, Mikkel Schou; Krone, Willy; Munthe, Sune
• Is Part Of: BMJ case reports. Volume 14:Issue 6(2021)
• Publication Date: 2021-06-30
• Subjects: neuroimaging -- radiology -- neurosurgery; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2021-241735
• Languages: English
• ISSNs: 1757-790X

Abstract

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.