TY - JOUR
T1 - Multimodal endovascular treatment of a vertebrovertebral fistula presenting with subarachnoid hemorrhage and hydrocephalus
AU - Walcott, Brian P.
AU - Berkhemer, Olvert A.
AU - Leslie-Mazwi, Thabele M
AU - Chandra, Ronil V.
AU - Ogilvy, Christopher S.
AU - Yoo, Albert J
PY - 2013/9
Y1 - 2013/9
N2 - Vertebrovertebral fistulae are rare vascular malformations that uncommonly can rupture to present clinically as intracranial subarachnoid hemorrhage. We report a 69-year-old man presenting following spontaneous apoplectic collapse. Initial workup revealed diffuse, intracranial subarachnoid hemorrhage, intraventricular hemorrhage and hydrocephalus. However, the etiology was not apparent on CT angiography of the head. Catheter-based angiography was performed, demonstrating a single-hole, high-flow vertebrovertebral fistula, arising from the V2 segment and decompressing into both cervical and skull base venous structures. Definitive treatment consisted of endovascular fistula obliteration with a combination of coil and liquid embolic material. The patient made a full neurological recovery. High cervical and skull base fistulae are rare causes of intracranial hemorrhage; endovascular treatment is effective at disconnection of the arteriovenous shunt.
AB - Vertebrovertebral fistulae are rare vascular malformations that uncommonly can rupture to present clinically as intracranial subarachnoid hemorrhage. We report a 69-year-old man presenting following spontaneous apoplectic collapse. Initial workup revealed diffuse, intracranial subarachnoid hemorrhage, intraventricular hemorrhage and hydrocephalus. However, the etiology was not apparent on CT angiography of the head. Catheter-based angiography was performed, demonstrating a single-hole, high-flow vertebrovertebral fistula, arising from the V2 segment and decompressing into both cervical and skull base venous structures. Definitive treatment consisted of endovascular fistula obliteration with a combination of coil and liquid embolic material. The patient made a full neurological recovery. High cervical and skull base fistulae are rare causes of intracranial hemorrhage; endovascular treatment is effective at disconnection of the arteriovenous shunt.
KW - Cervical
KW - Endovascular
KW - Hydrocephalus
KW - Stroke
KW - Subarachnoid
KW - Vertebral artery
KW - Vertebrovertebral fistula
UR - http://www.scopus.com/inward/record.url?scp=84883133961&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2013.01.006
DO - 10.1016/j.jocn.2013.01.006
M3 - Article
AN - SCOPUS:84883133961
VL - 20
SP - 1295
EP - 1298
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
SN - 0967-5868
IS - 9
ER -