A case of pediatric paraspinal arteriovenous fistula with multiple fistulas

Author:

Sato Shinsuke12ORCID,Niimi Yasunari3,Shima Shougo1,Moteki Yousuke23,Inoue Tatuya13,Kuwamoto Kentarou13,Okada Yoshikazu1

Affiliation:

1. Department of Neurosurgery, St. Luke’s International Hospital, Tokyo, Japan

2. Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan

3. Department of Neuroendovascular Therapy, St. Luke’s International Hospital, Tokyo, Japan

Abstract

Paraspinal arteriovenous fistula (AVF) is a rare vascular malformation. This is the first described case of a pediatric paraspinal AVF along nonvertebral segmental nerve with multiple fistulas. An 8 months-old girl was found to have a continuous murmur on the back on chest auscultation. Enhanced computed tomography revealed a segmental nerve AVF of the right thoracic spine. Selective angiography of the right T8 and T9 intercostal arteries demonstrated a high flow fistula at the level of the neural foramen, with drainage to the epidural and azygos veins. The fistulas point was visualized using Volume rendering(VR) and Minimum Intensity Projection(MIP) images. Endovascular treatment from the right T8 and T9 feeding arteries was provided using coils and n-butyl-2-cyanoacrylate(NBCA). Postembolization angiography demonstrated complete occlusion of the fistulas. The postoperative course was uneventful. We discuss the first case of a pediatric paraspinal AVF along nonvertebral segmental nerve with double holes of fistulas with literature review.

Publisher

SAGE Publications

Subject

Immunology

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