Turkish Neurosurgery
2015 , Vol 25 , Num 1
Vertebrojugular Arteriovenous Fistula and Pseudoaneurysm Formation due to Penetrating Vertebral Artery Injury: Case Report and Review of the Literature
1Kayseri Education and Research Hospital, Department of Neurosurgery, Kayseri, Turkey2Erciyes University, School of Medicine, Department of Radiology, Kayseri, Turkey
3Çankırı State Hospital, Department of Neurosurgery, Çankırı, Turkey DOI : 10.5137/1019-5149.JTN.8247-13.1 Vertebral artery injury including thrombosis, arteriovenous fistula (AVF), pseudo-aneurysm and hemorrhage may be iatrogenic or due to penetrating or blunt trauma. Although mostly asymptomatic, vertebral artery injury may also present with vertebrobasilar insufficiency findings, cephalgia, radicular pain or myelopathy due to blockade of arterial flow, arterial steal phenomenon and venous hypertension. The gold standard for diagnosis is digital subtraction angiography (DSA). Doppler ultrasonography, magnetic resonance-angiography and computerized tomography-angiography are also helpful. Endovascular treatment is now used more commonly. We present a case with sharp bread knife injury of the vertebral artery that was also complicated with a vertebrojugular fistula and pseudo-aneurysm together with the diagnostic and management options and a review of the current literature. Keywords : Vertebral artery, Penetrating injury, Vertebrojugular arteriovenous fistula, Pseudoaneurysm, Endovascular treatment