Atraumatic Vertebral Arteriovenous Fistula: A Rare Entity with Two Case Reports

Abstract

A vertebral artery arteriovenous fistula is rare and usually due to trauma. Atraumatic cases are quite rare. We reported 2 cases and a review of other reported studies. A spontaneous vertebral-venous fistula is rare, and the 2 cases presented illustrate an underlying spontaneous etiology. The first patient presented with a spontaneous fistula, and the second case occurred in a patient with neurofibromatosis type 1. In both cases, the fistulas were diagnosed using computed tomography angiography and treated with occlusion via coil embolization. Vascular changes are known in patients with neurofibromatosis. A proposed pathogenesis of fistula is that the fragility and defective nature of the arterial wall could be a predisposing factor or it might be congenital. Understanding the clinical symptoms, diagnosis, and effective management strategies are important for physicians treating patients with a vertebral artery arteriovenous fistula.