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Vertebral arteriovenous fistula due to blunt neck trauma: A case report

The arteriovenous fistulas (AVFs) of the vertebral artery are usually caused by iatrogenic and penetrating traumas. Vertebral AVF is rarely seen after blunt cervical trauma. A 65-year-old male patient applied to the emergency clinic due to falling from a height of about 3 m. In his neurological exam...

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Autores principales: Karakoyun, Durmuş Oğuz, Yılmaz, Ali, Uzlu, Oğuzhan, Daglioglu, Ergun, Işık, Hasan Serdar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10443019/
https://www.ncbi.nlm.nih.gov/pubmed/35652878
http://dx.doi.org/10.14744/tjtes.2020.72506
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author Karakoyun, Durmuş Oğuz
Yılmaz, Ali
Uzlu, Oğuzhan
Daglioglu, Ergun
Işık, Hasan Serdar
author_facet Karakoyun, Durmuş Oğuz
Yılmaz, Ali
Uzlu, Oğuzhan
Daglioglu, Ergun
Işık, Hasan Serdar
author_sort Karakoyun, Durmuş Oğuz
collection PubMed
description The arteriovenous fistulas (AVFs) of the vertebral artery are usually caused by iatrogenic and penetrating traumas. Vertebral AVF is rarely seen after blunt cervical trauma. A 65-year-old male patient applied to the emergency clinic due to falling from a height of about 3 m. In his neurological examination, he had weakness in the left upper limb and tinnitus in the left ear. The cervical computed tomography examination showed a Hangman’s fracture, a C3 vertebra corpus compression fracture, and a C1 anterior arch fracture. There was a separation on the C1-2 transverse foramen due to the fracture, and there was a fracture in the left C3-4 transverse foramen. In cervical magnetic resonance imaging (MRI), the presence of a contusion in the spinal cord at the C2 corpus level was observed. Through an MRI angiography examination of the vertebral artery, it was determined that the left vertebral artery had developed an AVF at the V2-3 segment level. Stabilization surgery was performed with a posterior approach for unstable vertebrae. Then, vertebral AVF was then closed endovascularly using a stent coil. Improvement in neurological deficit was seen after surgery and endovascular treatment. There were no complications related to the procedure. Transverse foramen should be carefully evaluated, especially in the upper cervical trauma. Vertebral artery imaging should be performed before instability surgery in the presence of a separation in the fracture line to determine whether the damage to the vertebral artery is iatrogenic.
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spelling pubmed-104430192023-08-23 Vertebral arteriovenous fistula due to blunt neck trauma: A case report Karakoyun, Durmuş Oğuz Yılmaz, Ali Uzlu, Oğuzhan Daglioglu, Ergun Işık, Hasan Serdar Ulus Travma Acil Cerrahi Derg Case Report The arteriovenous fistulas (AVFs) of the vertebral artery are usually caused by iatrogenic and penetrating traumas. Vertebral AVF is rarely seen after blunt cervical trauma. A 65-year-old male patient applied to the emergency clinic due to falling from a height of about 3 m. In his neurological examination, he had weakness in the left upper limb and tinnitus in the left ear. The cervical computed tomography examination showed a Hangman’s fracture, a C3 vertebra corpus compression fracture, and a C1 anterior arch fracture. There was a separation on the C1-2 transverse foramen due to the fracture, and there was a fracture in the left C3-4 transverse foramen. In cervical magnetic resonance imaging (MRI), the presence of a contusion in the spinal cord at the C2 corpus level was observed. Through an MRI angiography examination of the vertebral artery, it was determined that the left vertebral artery had developed an AVF at the V2-3 segment level. Stabilization surgery was performed with a posterior approach for unstable vertebrae. Then, vertebral AVF was then closed endovascularly using a stent coil. Improvement in neurological deficit was seen after surgery and endovascular treatment. There were no complications related to the procedure. Transverse foramen should be carefully evaluated, especially in the upper cervical trauma. Vertebral artery imaging should be performed before instability surgery in the presence of a separation in the fracture line to determine whether the damage to the vertebral artery is iatrogenic. Kare Publishing 2022-06-01 /pmc/articles/PMC10443019/ /pubmed/35652878 http://dx.doi.org/10.14744/tjtes.2020.72506 Text en Copyright © 2022 Turkish Journal of Trauma and Emergency Surgery https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
spellingShingle Case Report
Karakoyun, Durmuş Oğuz
Yılmaz, Ali
Uzlu, Oğuzhan
Daglioglu, Ergun
Işık, Hasan Serdar
Vertebral arteriovenous fistula due to blunt neck trauma: A case report
title Vertebral arteriovenous fistula due to blunt neck trauma: A case report
title_full Vertebral arteriovenous fistula due to blunt neck trauma: A case report
title_fullStr Vertebral arteriovenous fistula due to blunt neck trauma: A case report
title_full_unstemmed Vertebral arteriovenous fistula due to blunt neck trauma: A case report
title_short Vertebral arteriovenous fistula due to blunt neck trauma: A case report
title_sort vertebral arteriovenous fistula due to blunt neck trauma: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10443019/
https://www.ncbi.nlm.nih.gov/pubmed/35652878
http://dx.doi.org/10.14744/tjtes.2020.72506
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