BMJ Case Reports 2017; doi:10.1136/bcr-2016-218585

Anterior condylar confluence dural arteriovenous fistula: a rare cause of hoarseness

  1. Winston Eng Hoe Lim3
  1. 1Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore
  2. 2Department of Diagnostic Radiology, KK Women's and Children's Hospital, Singapore, Singapore
  3. 3Singapore General Hospital, Singapore, Singapore
  1. Correspondence to Dr Ghim Song Chia, ghimsong.chia{at}
  • Accepted 26 February 2017
  • Published 13 March 2017


Hoarseness secondary to an anterior condylar confluence (ACC) dural arteriovenous fistula (DAVF) has not been previously described. We present a 58-year-old patient with a 3-week history of progressive unilateral left-sided headaches and hoarseness. Nasolaryngoscopy and CT neck showed the presence of unilateral vocal cord palsy with no identifiable cause along the expected course of the recurrent laryngeal nerve. MRI revealed an incidental finding of abnormal serpiginous vessels in the left hypoglossal canal which led to a diagnostic cerebral angiogram, confirming the presence of an ACC DAVF. The patient underwent transvenous coil embolisation with subsequent resolution of arteriovenous shunting and symptoms. Follow-up MRI at 6 months showed no recurrence and there was complete resolution of clinical symptoms.


  • Contributors GSC prepared and revised the manuscript. WEHL performed the treatment, edited and approved the final version of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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