Ito Osamu, Nishimura Ataru, Ishido Katsuya, Hitotsumatsu Tsutomu
Department of Neurosurgery, Shin-Koga Hospital, Kurume-city, Fukuoka, Japan.
No Shinkei Geka. 2011 Aug;39(8):775-81.
A 61-year-old man presented with a rare case of spontaneous vertebral arteriovenous fistula manifesting as radiculopathy of the left arm. MRI demonstrated an abnormal dilated vascular space on the left ventral aspect of the spinal canal and compression of the spinal cord and subarachnoid space. MRA disclosed a single high-flow vertebral arteriovenous fistula. Angiography showed a direct high-flow fistula at the C2-3 level between the left vertebral artery and the spinal extradural veinous plexus, and an abnormal dilated left vertebral artery with "string of beads"-like feature. The fistula was successfully obliterated by coil embolization with preservation of patency of the left vertebral artery, resulting in improvement of the signs and symptoms. Retrospectively this spontaneous vertebral arteriovenous fistula was considered in association with fibromuscular dysplasia.
一名61岁男性患者，出现罕见的自发性椎动脉动静脉瘘，表现为左臂神经根病。MRI显示椎管左侧腹侧有异常扩张的血管间隙，脊髓和蛛网膜下腔受压。MRA显示单一的高流量椎动脉动静脉瘘。血管造影显示在C2-3水平左侧椎动脉与脊髓硬膜外静脉丛之间存在直接的高流量瘘，以及左侧椎动脉异常扩张，呈“串珠样”特征。通过弹簧圈栓塞成功闭塞了瘘，同时保留了左侧椎动脉的通畅，症状和体征得到改善。回顾性分析认为，该自发性椎动脉动静脉瘘与纤维肌发育不良有关。
