A rare form of out-of-hospital cardiopulmonary arrest due to spinal epidural arteriovenous fistula: A case report

•A spinal arteriovenous fistula (AVF) can lead to cardiac arrest, but survival from out-of-hospital cardiac arrest (OHCA) has never been reported.•An 84-year-old female developed out-of-hospital cardiac arrest due to rapture of AVF.•Magnetic resonance imaging showed arterio-venous malformation at C2...

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Bibliographic Details
Published in:	Interdisciplinary neurosurgery : Advanced techniques and case management Vol. 36; p. 101914
Main Authors:	Ban, Risako, Okuda, Akinori, Kogeichi, Yohei, Takano, Keisuke, Wada, Takeshi, Fukushima, Hidetada
Format:	Journal Article
Language:	English
Published:	Elsevier B.V 01-06-2024 Elsevier
Subjects:	Arteriovenous fistula Cardiac arrest Cervical spinal cord AVF CT Arteriovenous fistula OHCA ASV MRI Cardiac arrest AVM PMV PVP Cervical spinal cord
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Summary:	•A spinal arteriovenous fistula (AVF) can lead to cardiac arrest, but survival from out-of-hospital cardiac arrest (OHCA) has never been reported.•An 84-year-old female developed out-of-hospital cardiac arrest due to rapture of AVF.•Magnetic resonance imaging showed arterio-venous malformation at C2/3 level and angiography identified a spinal AVF.•Transarterial embolization of the AVF was performed on day 37. The patient recovered to Glasgow coma scale of 10 (E3VTM6), but no limb movements.•Future study will aid better management and outcome for this rare form of out-of-hospital cardiac arrest. A spinal arteriovenous fistula (AVF) can lead to cardiac arrest, but survival from out-of-hospital cardiac arrest (OHCA) has never been reported in the literature. An 84-year-old female called an ambulance because of sudden left hemiparesis. The emergency medical service crew found her in cardiac arrest. Upon hospital arrival, spontaneous circulation returned, and the patient was admitted to intensive care. She regained consciousness after targeted temperature management; however, no limb movements were observed. Since head computed tomography on arrival showed a high-density area at the cervical level, she underwent angiography, which revealed a spinal epidural AVF. Transarterial embolization of the AVF was performed. On day 70, the patient was transferred to a long-term care hospital under mechanical ventilation (cerebral performance category of 1 and modified Rankin Scale of 5). We reported a survival case of OHCA due to ruptured cervical epidural AVF. Optimal management for this condition requires further studies.
ISSN:	2214-7519 2214-7519
DOI:	10.1016/j.inat.2023.101914