Document Detail

Arteriovenous fistula of the vertebral artery in a female infant with hypotonia and cephalocorporal disproportion.
MedLine Citation:
PMID:  20394587     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Congenital arteriovenous fistulas are exceptional in childhood and imply a therapeutic challenge.
CASE REPORT: A 9-month-old female infant was studied for cephalocorporal disproportion, hypotonia, progressive muscular atrophy and hyperreflexia. Computed tomography of the brain and electroencephalography were normal. Electromyographic patterns suggested proximal myopathic involvement. A continuous murmur with systolic reinforcement was audible in the neck. Angioresonance detected intracranial aneurysmal dilatations behind the bulbo-medullary junction and cerebral panangiography evidenced a direct vertebrovertebral fistula with extra- and intra-cranial varices and extreme medullary compression. Occlusion of the afferent vessel to the aneurismal sack was successfully achieved with a mixture of Histoacryl and 75% lipiodol via a microcatheter.
CONCLUSION: Clinical signs of an arteriovenous fistula may be atypical. Considerable cephalocorporal disproportion and a bruit in the cervical or retromastoidal regions must suggest its existence. Complete obliteration with endovascular embolization permits somatic and neurological recovery.
F Núñez; Cecilia Martínez-Costa; F Soler; R Guijarro-Martínez; M L Castelló; J Brines
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  99     ISSN:  1651-2227     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-10-12     Completed Date:  2011-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  1434-6     Citation Subset:  IM    
Copyright Information:
© 2010 The Author(s)/Journal Compilation © 2010 Foundation Acta Paediatrica.
Pediatric Cardiology Unit, Hospital Clínico Universitario of Valencia, Valencia, Spain.
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MeSH Terms
Arteriovenous Fistula* / diagnosis,  therapy
Craniofacial Abnormalities / etiology*
Embolization, Therapeutic
Failure to Thrive / etiology
Magnetic Resonance Angiography
Muscle Hypotonia / etiology*
Spinal Cord Compression / etiology
Vertebral Artery*

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