Department of General Internal Medicine, St Luke's International University, Chuo-ku, Japan
Department of General Internal Medicine, Toyota Regional Medical Center, Toyota, Aichi, Japan.
BMJ Case Rep. 2021 Feb 22;14(2):e239880. doi: 10.1136/bcr-2020-239880.
We present the case of a 47-year-old woman with neurofibromatosis type 1 (NF1) with subarachnoid haemorrhage (SAH) from the left vertebral arteriovenous fistula, along with a review of previous cases. Our patient had a family history of NF1 and presented to the emergency department with a sudden-onset severe headache and neck pain. CT scan showed SAH. CT angiography revealed a left vertebral arteriovenous fistula and an epidural haematoma. She underwent direct surgery and was discharged without neurologic deficits. To our knowledge, this is the first case of SAH caused by perimedullary drainage of a vertebral arteriovenous fistula associated with NF1. In a literature search, we identified 40 cases of vertebral arteriovenous fistula associated with NF1. The majority of vertebral arteriovenous fistulas occurred on the left side and in women. Patients with vertebral arteriovenous fistula typically experience neck pain, radiculopathy, radiculomyelopathy and bruits.
我们报告了一例 47 岁的 1 型神经纤维瘤病(NF1)患者,因左侧椎动静脉瘘导致蛛网膜下腔出血(SAH),并对以往病例进行了回顾。该患者有 NF1 的家族史,因突发剧烈头痛和颈部疼痛就诊于急诊科。CT 扫描显示 SAH。CT 血管造影显示左侧椎动静脉瘘和硬膜外血肿。她接受了直接手术治疗,出院时无神经功能缺损。据我们所知,这是首例 NF1 合并硬脊膜引流导致的 SAH。在文献检索中,我们共确定了 40 例与 NF1 相关的椎动静脉瘘病例。大多数椎动静脉瘘发生在左侧和女性中。椎动静脉瘘患者通常表现为颈部疼痛、神经根病、神经根脊髓病和杂音。