An angiographic complication of vertebral arteriovenous fistula.

Complications of percutaneous angiography have been recorded and reported periodically throughout the literature (Abbott, Gay, and Goodall, 1952; Perese, Kite, Bedell, and Campbell, 1954). These complications range from something so minor as a transient Babinski response to immediate or eventual fatality. The following case is described so that an opportunity is afforded to visualize a vertebral arteriovenous fistula arising as a complication of percutaneous carotid angiography. Three cases have previously been recorded but all followed intended direct percutaneous vertebral angiography (Jamieson, 1965; Olson, Baker, and Svien, 1963; Sutton, 1962). Numerous other reports of vertebral arteriovenous fistula exist (Davis, 1960; Elkin and Harris, 1946; Heifetz, 1945; Matas, 1893). By far the majority are due to missile and stab wounds although there is one report (Svolos, Nomikos, and Tzouliadis, 1965) of a congenital lesion and an occasional instance of blunt trauma to the neck, with or without bony fracture, as being the aetiological agent (Elkin and Harris, 1946). Matas (1893), in a scholarly review of the literature up to 1893, also cites a case secondary to being gored by an ox and two cases associated with cervical tuberculosis.