Spontaneous resolution of a non-traumatic vertebro-vertebral arteriovenous fistula in a paediatric patient.

We report the case of a 10 year old male who presented with right sided tinnitus and a pulsatile neck mass. MRI of the neck demonstrated a vertebro-vertebral arteriovenous fistula (VAVF), with supply from the right vertebral artery and drainage into a paraspinal venous plexus at C1/2. Endovascular treatment would have necessitated vertebral artery sacrifice with significant risk of complication, therefore a conservative approach was adopted; the patient was lost to follow up but presented 5 years later with complete resolution. We therefore advocate a role for conservative management when treatment would pose undue risk.