Epidural Arteriovenous Fistula in the Cervical Spine Associated with Unilateral Upper Extremity Pain - A Case Report -

Jong-Woo Chae; Han Chang; Ho-Jin Nam; Myung-Sang Moon

doi:10.4184/jkss.2006.13.1.59

Journal List > J Korean Soc Spine Surg > v.13(1) > 1035749

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Chae, Chang, Nam, and Moon: Epidural Arteriovenous Fistula in the Cervical Spine Associated with Unilateral Upper Extremity Pain - A Case Report -

A Case Report

Journal of Korean Spine Surg 2006;13(1):59-63.

Published online: 12 February 2006

DOI: https://doi.org/10.4184/jkss.2006.13.1.59

Epidural Arteriovenous Fistula in the Cervical Spine Associated with Unilateral Upper Extremity Pain - A Case Report -

Jong-Woo Chae, M.D., Han Chang, M.D., Ho-Jin Nam, M.D., Myung-Sang Moon, M.D.

Spine Center, Department of Orthopaedic Surgery, Sun General Hospital, Daejeon, Korea

Address reprint requests to Han Chang, M.D. Department of Orthopaedic Surgery, Sun General Hospital 10-7, Mok-dong, Chung-gu, Daejeon 301-725, Korea Tel: 82-42-220-8150, Fax: 82-42-220-8159, E-mail: hc5771@chollian.net

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We experienced a rare case of an epidural arteriovenous fistula, which presented with symptoms similar to those of cervical radiculopathy. A n 18- years- old woman suffered from neck pain, which radiated to the left upper extremity for 4 months. On neurologic examination, there were sensory impairments of the left C4 to C8 dermatomes and intermittent weakness in both lower extremities after exercise. A n MRI of the cervical spine demonstrated a mass, which produced a serpentine- like signal void within the spinal canal from C1 to C7. The feeding artery of the fistula and the arterialized epidural venous plexus within the spinal canal were found on vertebral angiography. One year after an endovascular embolization with platinum coils, the clinical symptoms resolved and complete resolution of the arteriovenous fistula was confirmed by angiogram and MRI scan.

Keywords: Epidural A rteriovenous Fistula, Endovascular Embolization

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Fig. 1.

(A) Pre-embolization MRI at C3-4 level. The cervical dura is compressed by dilated, engorged epidural veins and feeding artery is located in the left C 3-4 intervertebral foramen. (B) Left vertebral angiography shows cervical vascular abnormality comparing to normal right side vertebral artery.

Fig. 2.

(A) Abnormal fistular flow through feeding artery is shown at C3-4 intervertebral foramen. (B) Schematic drawings of the left vertebral angiogram.

Fig. 3.

(A) Schematic plan of the endovascular embolization with platinium coils. (B) Post-embolization angiography shows the complete loss of the extradural arteriovenous fistula and the preservation of left side vertebral artery.

Fig. 4.

(A) Postoperative cervical radiogram. (B) Postoperative cervical spine MRIs show the complete loss of the extradural arteriovenous fistula.

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