Spontaneous vertebral arteriovenous fistula. Ultrasonographic detection and follow-up investigation after endovascular therapy

Spontaneous or traumatic arteriovenous fistulae between vertebral artery an d the surrounding Venous plexus may cause vertebrobasilar hypoperfusion by steal effects. We report on a 71-year-old man presenting with vertigo. Dupl ex sonography revealed a vertebral arteriovenous fistula at the C4/5 level with the typical perivascular color Doppler artifact and hyperperfusion in the supplying arteries and draining veins. Angiography confirmed the findin gs; the consequently performed endovascular embolization using platin coils and silicon balloon removed the symptoms immediately Ultrasonographic foll ow-up examinations within 5 months demonstrated the success of therapy show ing only low-flow fistula yet. This case demonstrates that early detection of a vertebral arteriovenous fistula by duplex sonography is highly benefic ial because efficient treatment modalities are available.