Cervical extradural arteriovenous fistula with radiculopathy managed endovascularly

Gabrielle Santangelo; Aman Singh; Redi Rahmani; Alexander Kessler; Matthew Bender

doi:10.25259/SNI_306_2023

Cervical extradural arteriovenous fistula with radiculopathy managed endovascularly

Surg Neurol Int. 2023 Jul 28:14:265. doi: 10.25259/SNI_306_2023. eCollection 2023.

Authors

Gabrielle Santangelo¹, Aman Singh¹, Redi Rahmani¹, Alexander Kessler², Matthew Bender¹

Affiliations

¹ Department of Neurosurgery,University of Rochester, Strong Memorial Hospital, Rochester, New York, United States.
² Department of Radiology, University of Rochester, Strong Memorial Hospital, Rochester, New York, United States.

Abstract

Background: Extradural arteriovenous fistulas (AVFs) of the cervical spine are extremely rare, and typically manifest as slowly progressive myelopathy caused by mass effect. This is a unique case of extradural AVF of the cervical spine manifesting with purely radicular symptoms and treated endovascularly with coil and liquid embolization.

Case description: A 55-year-old woman presented with neck pain and right upper extremity radiculopathy persisting for 9 months. Imaging studies demonstrated an AVF spanning from C4-C6 with extension into the C5-C6 foramen supplied primarily from the deep cervical branch of the costocervical trunk. The patient underwent successful coil and liquid (Onyx) embolization. Six-week postoperatively, the patient's symptoms completely resolved and magnetic resonance imaging and angiographic imaging confirmed complete obliteration of the fistula.

Conclusion: While extradural AVFs typically present with myelopathic symptoms, they may present with solely radicular symptoms and can be successfully treated endovascularly.

Keywords: Arteriovenous fistula; Cervical; Extradural; Radiculopathy; Therapeutic embolization.

Publication types

Case Reports