Neurofibromatosis Type 1-Associated Extracranial Vertebral Artery Aneurysm Complicated by Vertebral Arteriovenous Fistula After Rupture: Case Report and Literature Review
| Autor: | Kenta Suzuki, Kimihiro Yoshino, Masatoshi Yunoki, Koji Hirashita, Atsuhito Uneda, Shuichi Okubo |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Neurofibromatosis 1 Computed Tomography Angiography Vertebral artery Arteriovenous fistula Aneurysm Ruptured 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Aneurysm Hematoma medicine.artery medicine Humans cardiovascular diseases Neurofibromatosis Vertebral Artery Computed tomography angiography medicine.diagnostic_test business.industry medicine.disease Hemothorax Embolization Therapeutic Surgery Angiography Arteriovenous Fistula cardiovascular system Female Neurology (clinical) Radiology business 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 96 |
| ISSN: | 1878-8769 |
| Popis: | Background Extracranial vertebral artery aneurysm related to neurofibromatosis type 1 (NF1) is rare. Aneurysmal rupture typically induces such symptoms as cervical hematoma, hemothorax, and hypotension. Here we report a case of ruptured extracranial vertebral artery aneurysm in a patient with NF1 who, rather than cervical hematoma, hemothorax, or hypotension, developed a vertebral arteriovenous fistula (AVF) after aneurysm rupture. Case Description A 35-year-old woman with a family history of NF1 presented with sudden-onset right neck and shoulder pain. Computed tomography angiography showed a right extracranial vertebral artery aneurysm. She had neither a cervical hematoma nor hypotension; however, angiography showed an AVF secondary to aneurysmal rupture. The patient was treated with endovascular coil embolization to prevent re-rupture. Postoperatively, her right neck and shoulder pain improved, and she was discharged without further neurologic deficits. Conclusions This patient's clinical course suggests that if there is minimal bleeding from an NF1-associated ruptured extracranial vertebral artery aneurysm, then typical symptoms, such as cervical hematoma, hemothorax, and hypotension, may be absent. Thus, ruptured extracranial vertebral artery aneurysm should be considered in the differential diagnosis of patients with NF1 with sudden-onset radiculopathy, even in the absence of typical symptoms. The detection of a vertebral AVF provides a useful clue to the diagnosis of aneurysm rupture in such cases. |
| Databáze: | OpenAIRE |
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