Hemiparesis to quadriplegia in NF 1 patient: A case report of endovascular thromboembolization and literature review

NF-1 with VVAVF is a rare neurological disorder with multimodal presentation. The safety and efficacy of endovascular thromboembolization in vertebro-vertebral arteriovenous fistulas (VVAVF) associated with NF-1(neurofibromatosis) remains controversial. Here, we have reported a case presentation and management including clinically effective surgical approach in NF-1 associated VVAVF. A literature review of the published literature using PubMed, Google scholar and Scopus was performed to identify case reports of VVAVF over the last 10 years (2015-2025). We extracted clinical, imaging information and outcome following treatment to evaluate the efficacy of thromboembolization. The patient presented with neck pain and bilateral limb weakness. MRI revealed spinal cord compression and gross myelopathy. After proper preoperative preparation, embolization was performed using embolic agents and microcatheters followed by uneventful post operative period (MRC grade 5/5 in both extremities) and diminished limb weakness. As well as, through literature review, seven VVAVF cases were reported associated with NF-1, showing manifestations, post operative outcome with selected materials and procedure. The outcome highlights the significance of thromboembolization due to the less recurrence of occlusion. Additionally, this review also appreciates selection of proper and sustained materials and embolic agents or following hybrid approach according to clinical scenario and location of fistula.