Sajjad Muhammad1*, Jussi Numminen2, Atte Karppinen1 and Mika Niemelä1
1Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Finland
2Department of Neuroradiology, University of Helsinki and Helsinki University Hospital, Finland
Background: Extracranial vertebral artery AVF are extremely rare and there is no standardized treatment for such aneurysms. Treatment of an unruptured V1-segment vertebral artery-vertebral vein fistula in a pediatric patient has rarely been described in literature. Case
Presentation: We present a case of a 6year-old child with an incidental V1-segment vertebral artery AVF. During a routine pediatric auscultation of the heart, a bruit over the supraclavicular region was heard. Initial ultrasound showed suspicion of aneurysm of vertebral artery. CT-angiogram and DSA showed a V1-segment vertebral artery fistula. The patient was treated successfully with coil embolization. The vertebral artery was spared and reconstructed successfully during embolization without any complications. The child is now 9 years old and follow-up MRI scans in 2018 showed complete occlusion 3 years after intervention.
Conclusion: Endovascular coiling sparing vertebral artery is a safe, effective, and reliable treatment modality in pediatric cases of V1-segment vertebral artery fistula with the adjacent vein.
V1-segment vertebral artery fistula; Coil embolization; Pediatric case
Muhammad S, Numminen J, Karppinen A, Niemel� M. Treatment of a Spontaneous Vertebral Artery-Vertebral Vein Arteriovenous Fistula (AVF) in a Paediatric Patient. Clin Surg. 2019; 4: 2451.