Arteriovenous fistula of the vertebral artery in a female infant with hypotonia and cephalocorporal disproportion

Background:  Congenital arteriovenous fistulas are exceptional in childhood and imply a therapeutic challenge. Case report: A 9-month-old female infant was studied for cephalocorporal disproportion, hypotonia, progressive muscular atrophy and hyperreflexia. Computed tomography of the brain and electroencephalography were normal. Electromyographic patterns suggested proximal myopathic involvement. A continuous murmur with systolic reinforcement was audible in the neck. Angioresonance detected intracranial aneurysmal dilatations behind the bulbo-medullary junction and cerebral panangiography evidenced a direct vertebrovertebral fistula with extra- and intra-cranial varices and extreme medulla…