[Spontaneous vertebral arteriovenous fistula. Detection and treatment follow-up with color-coded duplex ultrasound].
Spontaneous or traumatic arteriovenous fistulae between vertebral artery and the surrounding venous plexus may cause vertebrobasilar hypoperfusion by steal effects. We report on a 71-year-old man presenting with vertigo. Duplex sonography revealed a vertebral arteriovenous fistula at the C4/5 level with the typical perivascular color Doppler artifact and hyperperfusion in the supplying arteries and draining veins. Angiography confirmed the findings; the consequently performed endovascular embolization using platin coils and silicon balloon removed the symptoms immediately. Ultrasonographic follow-up examinations within 5 months demonstrated the success of therapy showing only low-flow fistula yet. This case demonstrates that early detection of a vertebral arteriovenous fistula by duplex sonography is highly beneficial because efficient treatment modalities are available.
Arning
C
C
Abteilung Neurologie, Allgemeines Krankenhaus, Hamburg-Barmbek.
Grzyska
U
U
Hammer
E
E
Lachenmayer
L
L
D000368:Aged; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000628:therapy; D002574:Cervical Vertebrae / Q000098:blood supply; D004621:Embolization, Therapeutic; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014680:Veins / Q000000981:diagnostic imaging; D014711:Vertebral Artery / Q000000981:diagnostic imaging*; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000628:therapy