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

BMJ Case Rep. 2017 Mar 13:2017:bcr2016218585. doi: 10.1136/bcr-2016-218585.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Central Nervous System Vascular Malformations / complications*
  • Central Nervous System Vascular Malformations / diagnosis*
  • Central Nervous System Vascular Malformations / diagnostic imaging
  • Central Nervous System Vascular Malformations / therapy
  • Cerebral Angiography / methods
  • Diagnosis, Differential
  • Embolization, Therapeutic / methods
  • Headache / etiology
  • Hoarseness / etiology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged