[Postarteriographic vertebral arteriovenous fistula].

The vertebral artetio-venous fistulas are seldom reported as a complication of the carotid angiography. As emphasized in this case report it's difficult to identify the place of the communication between the vein and the artery. It explains that two operations were necessary before the total exclusion of the fistula. The study of the literature recalls the main clinical features in that sort of fistula, constituted by the subjective and objective perception of a hum. The more often related complications consist in vertebro-basilar insufficiency, symptoms of root or spinal-cord squeezing, ischemic brain pathology, or cervical tumor. It's often difficult to read the angiograms because of the presence of a lot of enlarged veins. The therapy of that kind of fistula may consist in: --trapping of the fistula, but the symptoms may reappear after a few days due to the local anastomosis, --direct surgery with occlusion of the fistula which is difficult and also presents risks of recurrence (cf our case), --embolisation which looks interesting and could become the best mean of treatment in the future.