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Spontaneous Regression Of An Idiopathic Arteriovenous Fistula Of The Right Vertebral Artery

Choudhri, O. 2018Other/Unknown

Choudhri, O., Dobre, M. C., Feroze, A., Sharma, N., & Do, H. M. (2018). Spontaneous regression of an idiopathic arteriovenous fistula of the right vertebral artery. Neuroradiology, 60(2), 221–223. https://doi.org/10.1007/s00234-017-1963-3

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Abstract

A previously healthy 53-year-old male presented with a 2-month history of pulsatile tinnitus, worsening headaches, and neck pain. Given the clinical symptoms, a workup was initiated to assess for a vascular etiology such as a dural arteriovenous fistula.

Case Details

Disease Location

Sigmoid sinuses and jugular bulbs

Personal Characteristics

53-year-old male

Clinical Characteristics

2-month history of pulsatile tinnitus, worsening headaches, and neck pain. Mr imaging demonstrated prominence of the paravertebral veins. Additionally, mr with arterial spin labeling (asl) demonstrated an abnormally high signal in the region of bilateral sigmoid sinuses and jugular bulbs, consistent with arteriovenous shunting. Diagnostic cerebral angiography confirmed a high-flow arteriovenous (av) fistula involving the right vertebral artery

Remission Characteristics

The patient noted an improvement in his tinnitus. Two weeks after the initial imaging, a cerebral angiogram completed subsequently demonstrated a complete resolution of the right-sided high-flow av fistula of the right vertebral artery.

Treatment & Mechanisms

Proposed Remission Mechanisms

Possible that neck turning and vertebral artery movement potentially decrease flow through the fistula, contributing to spontaneous regression

Non-Clinical Treatment

None reported