• Rabjot Rai, Joe Iwanaga, Bill Wang, Akil Patel, Joshua Bentley, Yince Loh, Stephen Monteith, and R Shane Tubbs.
• Seattle Science Foundation, Seattle, Washington, USA.
• World Neurosurg. 2018 Dec 1; 120: 66-71.

BackgroundA vertebral artery arteriovenous fistula is rare and usually due to trauma. Atraumatic cases are quite rare. We reported 2 cases and a review of other reported studies.Case DescriptionA spontaneous vertebral-venous fistula is rare, and the 2 cases presented illustrate an underlying spontaneous etiology. The first patient presented with a spontaneous fistula, and the second case occurred in a patient with neurofibromatosis type 1. In both cases, the fistulas were diagnosed using computed tomography angiography and treated with occlusion via coil embolization.ConclusionsVascular changes are known in patients with neurofibromatosis. A proposed pathogenesis of fistula is that the fragility and defective nature of the arterial wall could be a predisposing factor or it might be congenital. Understanding the clinical symptoms, diagnosis, and effective management strategies are important for physicians treating patients with a vertebral artery arteriovenous fistula.Copyright © 2018. Published by Elsevier Inc.

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