Frontiers in Neurology (Jun 2023)

New aneurysm formation after endovascular embolization of a vertebral epidural AV fistula: a rare sequelae of NF AV fistulae

  • Yiyong Zeng,
  • Xianru Li,
  • Junjun Zhang,
  • Yi Huang,
  • Yi Huang,
  • Zhiqin Lin,
  • Shengjun Zhou

DOI
https://doi.org/10.3389/fneur.2023.1132334
Journal volume & issue
Vol. 14

Abstract

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BackgroundNeurofibromatosis type 1 (NF-1) is a dominant genetic disorder often accompanied by lesions of the neurovascular system. Patients with NF-1 are predisposed to unique vertebral artery fistula (AVF).Case descriptionWe report on a rare case of multiple neurovascular abnormalities in a 47-year-old man with neurofibromatosis. He was admitted due to a sudden headache and was found to have suffered a subarachnoid hemorrhage from a left vertebral arteriovenous fistula. He underwent two endovascular procedures complicated by a delayed extraspinal mass 7 days after treatment. Angiography revealed a new vascular abnormality, and although we performed another embolization, it failed to respond to further embolization.ConclusionVascular abnormalities in patients with NF-1 can be complex. Endovascular intervention remains feasible for NF-1 related AVF, however, partial occlusion of the fistula should be avoided to limit and iatrogenic damage to the blood vessels.

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