Transarterial coil embolization of a high-flow vertebrojugular fistula due to penetrating craniocervical trauma: Case report

Brian A. O'Shaughnessy, Bernard R. Bendok, Richard J. Parkinson, Ali Shaibani, H. Hunt Batjer

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Vertebrojugular fistulas after penetrating cervical trauma (gunshot or stab wounds) are rarely reported. Successful endovascular coil embolization of an acute fistulizing vertebral artery pseudoaneurysm involving an obstructed internal jugular vein is presented and the various treatment strategies for such a lesion are described. Case Description: A 23-year-old man presented from an outside institution after sustaining 2 gunshot wounds in a civilian conflict. Neuroimaging revealed a right vertebral artery pseudoaneurysm, which formed a fistulous connection with the internal jugular vein. Because venous outflow obstruction was present just below the fistula, a high-flow shunt was directed intracranially. Both the pseudoaneurysm and arteriovenous fistula were accessed percutaneously via a transfemoral route and coil embolization was performed. Perfusion of the basilar artery circulation was assumed by the contralateral vertebral artery. The ipsilateral posteroinferior cerebellar artery filled through retrograde flow down the vertebral confluence. Conclusions: Coil embolization is a safe and reliable strategy by which to obliterate an acute traumatic vertebrojugular fistula as well as pseudoaneurysm. Serial angiographic follow-up is mandatory to document a persistent cure.

Original languageEnglish (US)
Pages (from-to)335-340
Number of pages6
JournalSurgical Neurology
Volume64
Issue number4
DOIs
StatePublished - Oct 2005

Fingerprint

False Aneurysm
Fistula
Vertebral Artery
Gunshot Wounds
Jugular Veins
Wounds and Injuries
Stab Wounds
Basilar Artery
Arteriovenous Fistula
Neuroimaging
Arteries
Perfusion
Therapeutics

Keywords

  • Arteriovenous fistula
  • Coil embolization
  • Pseudoaneurysm
  • Vertebrojugular

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Transarterial coil embolization of a high-flow vertebrojugular fistula due to penetrating craniocervical trauma : Case report. / O'Shaughnessy, Brian A.; Bendok, Bernard R.; Parkinson, Richard J.; Shaibani, Ali; Batjer, H. Hunt.

In: Surgical Neurology, Vol. 64, No. 4, 10.2005, p. 335-340.

Research output: Contribution to journalArticle

O'Shaughnessy, Brian A. ; Bendok, Bernard R. ; Parkinson, Richard J. ; Shaibani, Ali ; Batjer, H. Hunt. / Transarterial coil embolization of a high-flow vertebrojugular fistula due to penetrating craniocervical trauma : Case report. In: Surgical Neurology. 2005 ; Vol. 64, No. 4. pp. 335-340.
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