Multimodal endovascular treatment of a vertebrovertebral fistula presenting with subarachnoid hemorrhage and hydrocephalus

Brian P. Walcott, Olvert A. Berkhemer, Thabele M Leslie-Mazwi, Ronil V. Chandra, Christopher S. Ogilvy, Albert J Yoo

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8 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)1295-1298
Number of pages4
JournalJournal of Clinical Neuroscience
Issue number9
Publication statusPublished - Sept 2013
Externally publishedYes


  • Cervical
  • Endovascular
  • Hydrocephalus
  • Stroke
  • Subarachnoid
  • Vertebral artery
  • Vertebrovertebral fistula

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