Head and Neck Imaging

Arteriovenous fistula, head and neck

abnormal communication between an artery and a vein that bypasses the normal capillary bed. This term is best reserved for traumatic communications (Fig.1), while a congenital lesion is better described as an arteriovenous malformation head and neck.

Near the skull base, an arteriovenous fistula may cause tinnitus. In a dural arteriovenous fistula, there is an abnormal communication between a branch of the carotid artery and a dural sinus; this is a rare lesion, but a more common cause of tinnitus than a cerebral arteriovenous malformation. A direct arteriovenous fistula may occur in the vertebral artery (with the surrounding venous plexus) or in the internal carotid artery (usually with the cavernous sinus), or may involve a branch of the external carotid artery.

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Fig.1

Patient with post-traumatic pulsatile swelling in neck. Gadolinium-enhanced axial T1-weighted spin echo image (a) shows a small enhancing region, containing some flow voids, in the right sternocleidomastoid muscle (arrow). Selective arteriography (b) reveals a hypertrophic muscular branch of the occipital artery, feeding a collection of tortuous vessels, and early drainage to the internal jugular vein (5).
Arteriovenous fistula, head and neck, Fig.1 (a)
Arteriovenous fistula, head and neck, Fig.1 (b)