Neurological Surgery No Shinkei Geka Volume 37, Issue 7 (July 2009)

Vertebral Arteriovenous Fistula Presenting with Subarachnoid Hemorrhage: A Case Report Takeshi HIU 1 , Tsutomu YOSHIOKA 1 , Naoki KITAGAWA 2 , Tsuyoshi IZUMO 1 , Tomohiro OKUNAGA 1 , Kazuhiko SUYAMA 2 , Hiroaki YOKOYAMA 1 , Izumi NAGATA 2 1Department of Neurosurgery,Nagasaki Rousai Hospital 2Department of Neurosurgery,Nagasaki University Graduate School of Biomedical Sciences Keyword: subarachnoid hemorrhage , vertebral arteriovenous fistula pp.667-671
Published Date 2009/7/10
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 We report a rare case of a vertebral arteriovenous fistula presenting with subarachnoid hemorrhage (SAH). A 60-year-old man was admitted to our hospital with a sudden onset of headache and neck pain. A neurological examination showed no abnormalities. Computed tomography scans revealed SAH in the pontine cistern and cistern magna. Although the first cerebral angiogram failed to depict the cause of bleeding, the second angiogram on day 15 demonstrated an arteriovenous fistula in the left vertebral artery at C4-5, which was draining into the internal vertebral venous plexus and forming a venous pouch. The fistula was successfully obliterated by transarterial embolization using detachable platinum coils. In patients with SAH with predominance in the posterior fossa, attention should also be paid to spinal vascular lesions. Three-dimensional digital angiography and digital subtraction angiography allow a reliable visualization of such lesions.

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Neurological Surgery 脳神経外科
37巻7号 (2009年7月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院