Stent-Assisted Coil Embolization of a Vertebro-Vertebral Arteriovenous Fistula Secondary to Oriental Acupuncture: A Case Report

A vertebro-vertebral arteriovenous fistula is an abnormal communication between the vertebral artery and adjacent venous structures. Trauma is the most common cause of vertebral arteriovenous fistulas; however, the fistulas can also occur spontaneously. We herein report a case of a traumatic vertebro-vertebral arteriovenous fistula that occurred following the application of oriental acupuncture in the posterior neck region. A 64-year-old previously healthy female patient took over-the-counter medicine for cervical pain that occurred several months before the acupuncture session but showed no improvement. She had undergone oriental acupuncture treatment in the posterior lower neck region 1 month before visiting our hospital. After the treatment, she gradually developed tinnitus, accompanied by dizziness. Abnormal aneurysmal dilated vessels were observed in the right vertebral artery on computed tomography angiography. The patient was immediately admitted and underwent diagnostic angiography. She subsequently underwent stent-assisted coil embolization, which gradually resolved her dizziness and tinnitus.