A Rare Case of Post-Traumatic Cervical Ligamentous Tear Complicated by Vertebral Arteriovenous Fistula (vAVF), with Successful Endovascular Treatment
Post-traumatic vertebral arteriovenous fistula (vAVF) caused by motor vehicle accidents (MVA) is a rare condition in which there is abnormal communication between the vertebral artery and its adjacent veins. In a post-MVA setting, it is commonly associated with vertebral body fracture. In this paper...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-08-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/13/16/2693 |
| _version_ | 1797584953334038528 |
|---|---|
| author | Abdul Rahim Nur Fazdlin Iqbal Hussain Rizuana Li Shyan Ch’ng |
| author_facet | Abdul Rahim Nur Fazdlin Iqbal Hussain Rizuana Li Shyan Ch’ng |
| author_sort | Abdul Rahim Nur Fazdlin |
| collection | DOAJ |
| description | Post-traumatic vertebral arteriovenous fistula (vAVF) caused by motor vehicle accidents (MVA) is a rare condition in which there is abnormal communication between the vertebral artery and its adjacent veins. In a post-MVA setting, it is commonly associated with vertebral body fracture. In this paper, we report a case of a 19-year-old girl with a complete C2/C3 anterior and posterior ligament tear post MVA without any cervical bony injury. Initial plain computed tomography (CT) cervical scan showed a prevertebral hematoma. A CT angiogram (CTA) raised the suspicion of a pseudo-aneurysm at the right posterior C3 vertebral body. Further imaging with magnetic resonance imaging (MRI) demonstrated traumatic AVF at the C2/C3 level involving the V2/V3 right vertebral artery to the vertebral venous plexus. Digital Subtraction Angiography (DSA) further revealed a transected right vertebral artery at the C2/C3 level with an arteriovenous fistula and an enlarged vertebral venous plexus. The fistulous communication was successfully occluded with coils from a cranial and caudal approach to the transected segment right vertebral artery, with a total of eight coils. Post-MVA vertebral arteriovenous fistula (vAVF) is a rare sequela of vertebral bony injury at the cervical region, and is an even rarer association with an isolated ligamentous injury, whereby endovascular treatment with ipsilateral vertebral artery closure is a feasible treatment of vAVF. |
| first_indexed | 2024-03-10T23:59:58Z |
| format | Article |
| id | doaj.art-25ce5eb394b347d9ba4bda4d2f6cbe1a |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T23:59:58Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-25ce5eb394b347d9ba4bda4d2f6cbe1a2023-11-19T00:48:46ZengMDPI AGDiagnostics2075-44182023-08-011316269310.3390/diagnostics13162693A Rare Case of Post-Traumatic Cervical Ligamentous Tear Complicated by Vertebral Arteriovenous Fistula (vAVF), with Successful Endovascular TreatmentAbdul Rahim Nur Fazdlin0Iqbal Hussain Rizuana1Li Shyan Ch’ng2Department of Radiology, Faculty of Medicine, University Kebangsaan, Bangi 43600, MalaysiaDepartment of Radiology, Faculty of Medicine, University Kebangsaan, Bangi 43600, MalaysiaDepartment of Radiology, Faculty of Medicine, Universiti Teknologi Mara, Sungai Buloh 47000, MalaysiaPost-traumatic vertebral arteriovenous fistula (vAVF) caused by motor vehicle accidents (MVA) is a rare condition in which there is abnormal communication between the vertebral artery and its adjacent veins. In a post-MVA setting, it is commonly associated with vertebral body fracture. In this paper, we report a case of a 19-year-old girl with a complete C2/C3 anterior and posterior ligament tear post MVA without any cervical bony injury. Initial plain computed tomography (CT) cervical scan showed a prevertebral hematoma. A CT angiogram (CTA) raised the suspicion of a pseudo-aneurysm at the right posterior C3 vertebral body. Further imaging with magnetic resonance imaging (MRI) demonstrated traumatic AVF at the C2/C3 level involving the V2/V3 right vertebral artery to the vertebral venous plexus. Digital Subtraction Angiography (DSA) further revealed a transected right vertebral artery at the C2/C3 level with an arteriovenous fistula and an enlarged vertebral venous plexus. The fistulous communication was successfully occluded with coils from a cranial and caudal approach to the transected segment right vertebral artery, with a total of eight coils. Post-MVA vertebral arteriovenous fistula (vAVF) is a rare sequela of vertebral bony injury at the cervical region, and is an even rarer association with an isolated ligamentous injury, whereby endovascular treatment with ipsilateral vertebral artery closure is a feasible treatment of vAVF.https://www.mdpi.com/2075-4418/13/16/2693vertebral arteriovenous fistulatraumaticendovascular |
| spellingShingle | Abdul Rahim Nur Fazdlin Iqbal Hussain Rizuana Li Shyan Ch’ng A Rare Case of Post-Traumatic Cervical Ligamentous Tear Complicated by Vertebral Arteriovenous Fistula (vAVF), with Successful Endovascular Treatment Diagnostics vertebral arteriovenous fistula traumatic endovascular |
| title | A Rare Case of Post-Traumatic Cervical Ligamentous Tear Complicated by Vertebral Arteriovenous Fistula (vAVF), with Successful Endovascular Treatment |
| title_full | A Rare Case of Post-Traumatic Cervical Ligamentous Tear Complicated by Vertebral Arteriovenous Fistula (vAVF), with Successful Endovascular Treatment |
| title_fullStr | A Rare Case of Post-Traumatic Cervical Ligamentous Tear Complicated by Vertebral Arteriovenous Fistula (vAVF), with Successful Endovascular Treatment |
| title_full_unstemmed | A Rare Case of Post-Traumatic Cervical Ligamentous Tear Complicated by Vertebral Arteriovenous Fistula (vAVF), with Successful Endovascular Treatment |
| title_short | A Rare Case of Post-Traumatic Cervical Ligamentous Tear Complicated by Vertebral Arteriovenous Fistula (vAVF), with Successful Endovascular Treatment |
| title_sort | rare case of post traumatic cervical ligamentous tear complicated by vertebral arteriovenous fistula vavf with successful endovascular treatment |
| topic | vertebral arteriovenous fistula traumatic endovascular |
| url | https://www.mdpi.com/2075-4418/13/16/2693 |
| work_keys_str_mv | AT abdulrahimnurfazdlin ararecaseofposttraumaticcervicalligamentoustearcomplicatedbyvertebralarteriovenousfistulavavfwithsuccessfulendovasculartreatment AT iqbalhussainrizuana ararecaseofposttraumaticcervicalligamentoustearcomplicatedbyvertebralarteriovenousfistulavavfwithsuccessfulendovasculartreatment AT lishyanchng ararecaseofposttraumaticcervicalligamentoustearcomplicatedbyvertebralarteriovenousfistulavavfwithsuccessfulendovasculartreatment AT abdulrahimnurfazdlin rarecaseofposttraumaticcervicalligamentoustearcomplicatedbyvertebralarteriovenousfistulavavfwithsuccessfulendovasculartreatment AT iqbalhussainrizuana rarecaseofposttraumaticcervicalligamentoustearcomplicatedbyvertebralarteriovenousfistulavavfwithsuccessfulendovasculartreatment AT lishyanchng rarecaseofposttraumaticcervicalligamentoustearcomplicatedbyvertebralarteriovenousfistulavavfwithsuccessfulendovasculartreatment |