[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.