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E-024 Spontaneous vertebral arteriovenous fistula mimicking brachial radiculo-plexopathy: a case report
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  1. A Larson1,
  2. L Rinaldo1,
  3. C Arnold Fiebelkorn2,
  4. N Young2,
  5. G Lanzino1
  1. 1Neurosurgery, Mayo Clinic, Rochester, MN
  2. 2Neurology, Mayo Clinic, Rochester, MN

Abstract

Vertebral arteriovenous fistulas (VAVF) are uncommon, high-flow communications between a vertebral artery and surrounding venous plexus that occur spontaneously or secondary to trauma. A 57-year-old female presented with a multi-day history of rapidly progressive numbness and weakness in the left C5-C6 dermomyotomes. Her physical exam findings and subsequent electrophysiological testing were suggestive of a brachial radiculo-plexopathy. Noninvasive imaging demonstrated venous congestion with multilevel compromise of the left-sided cervical foramina, and subsequent vertebral angiography confirmed a VAVF, which was treated with trapping of the involved VA segment. Her numbness and weakness progressively improved with concurrent involution of the dilated veins. An exceptional case of VAVF manifesting as a brachial radiculo-plexopathy is presented. VAVF are rare, though they may be considered as a potential underlying cause in patients with comparable symptoms. Endovascular embolization has been demonstrated as a safe and efficacious method in treating VAVFs, though multiple patient-specific factors must be contemplated.

Disclosures A. Larson: None. L. Rinaldo: None. C. Arnold Fiebelkorn: None. N. Young: None. G. Lanzino: None.

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