Saavedra-Pozo Fanor, Vicenty-Padilla Juan, Rodriguez-Mercado Rafael
Department of Surgery, Neurosurgery Section, University of Puerto Rico Medical Sciences Campus, San Juan, PR 00936.
J Craniovertebr Junction Spine. 2017 Jul-Sep;8(3):268-270. doi: 10.4103/jcvjs.JCVJS_49_17.
Vertebrojugular fistulas have been described in the literature associated with blunt or penetrating injury and iatrogenic or spontaneous development. Its presentation may be broad and may include symptoms of radiculopathy, vertebrobasilar insufficiency, tinnitus, and bruit. However, so far, no direct cardiac complications had been reported. Here, we describe a case of an 86-year-old female who suffered a C5 vertebral fracture secondary to a ground-level fall that was initially treated conservatively due to the onset of new severe atrial fibrillation. However, the patient was later on taken to surgery due to progressive neurologic deterioration. Intraoperative complications led to the diagnosis of a vertebral-jugular fistula that was successfully embolized. The effective obliteration of the fistulae led to the recovery of both neurologic and cardiac symptoms.
文献中已描述了与钝性或穿透性损伤以及医源性或自发性发展相关的椎静脉瘘。其表现可能多种多样,可能包括神经根病、椎基底动脉供血不足、耳鸣和杂音等症状。然而,迄今为止,尚未有直接心脏并发症的报道。在此,我们描述一例86岁女性患者,因平地跌倒导致C5椎体骨折,最初因新发严重心房颤动而采取保守治疗。然而,患者后来因进行性神经功能恶化而接受手术。术中并发症导致诊断为椎静脉瘘,该瘘成功栓塞。瘘管的有效闭塞使神经和心脏症状均得以恢复。