A rare case of a vertebrojugular arteriovenous fistula: A case report and review of literature. 2017

Fanor Saavedra-Pozo, and Juan Vicenty-Padilla, and Rafael Rodriguez-Mercado
Department of Surgery, Neurosurgery Section, University of Puerto Rico Medical Sciences Campus, San Juan, PR 00936.

Vertebrojugular fistulas have been described in the literature associated with blunt or penetrating injury and iatrogenic or spontaneous development. Its presentation may be broad and may include symptoms of radiculopathy, vertebrobasilar insufficiency, tinnitus, and bruit. However, so far, no direct cardiac complications had been reported. Here, we describe a case of an 86-year-old female who suffered a C5 vertebral fracture secondary to a ground-level fall that was initially treated conservatively due to the onset of new severe atrial fibrillation. However, the patient was later on taken to surgery due to progressive neurologic deterioration. Intraoperative complications led to the diagnosis of a vertebral-jugular fistula that was successfully embolized. The effective obliteration of the fistulae led to the recovery of both neurologic and cardiac symptoms.

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