title: [A Case of Traumatic Vertebral Arteriovenous Fistula Treated by Internal Trapping of the Vertebral Artery].
abstract: BACKGROUND
  Traumatic vertebral arteriovenous fistula (TVAVF) is an uncommon disease that occurs after traumatic injury. Here we report a case of TVAVF presenting with cervical bruit successfully treated by internal trapping using coils.
  
  
  METHODS
  A 66-year-old man was transferred to our hospital after falling into a ditch. Initial CT revealed a C2 fracture into the right transverse foramen, and the patient had been treated with conservative management. A vascular abnormality was suspected because the patient exhibited cervical bruit on admission. CT angiography revealed right TVAVF at the V2 segment of the right vertebral artery (VA) near the C2 fracture. Digital subtraction angiography also revealed right TVAVF between the V2 segment of the right VA and the vertebral venous plexus, draining into the right internal jugular vein and the deep cervical vein as well as the intracranial venous system. The fistula was also opacified by retrograde flow from the contralateral VA through the union, while the flow in the basilar artery was antegrade. The patient was diagnosed with TVAVF with large transection of the right VA, and underwent endovascular treatment with internal trapping of the right VA using coils starting distal to the transection and proceeding in a proximal direction. After treatment, the right VAVF and right VA were completely occluded. The patient achieved clinical symptom resolution with no neurological deficits.
  
  
  CONCLUSIONS
  Endovascular treatment with internal trapping of the VA using coils is safe and effective against TVAVF.
authors: Department of Neurological Surgery, Okayama University Graduate School of Medicine.
authors: Shingo
authors: S
authors: Nishihiro
authors: Kenji
authors: K
authors: Sugiu
authors: Tomohito
authors: T
authors: Hishikawa
authors: Masafumi
authors: M
authors: Hiramatsu
authors: Jun
authors: J
authors: Haruma
authors: Yukei
authors: Y
authors: Shinji
authors: Yuji
authors: Y
authors: Takasugi
authors: Isao
authors: I
authors: Date
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000601:surgery*; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D057772:Vascular System Injuries / Q000175:diagnosis / Q000601:surgery*; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*