Dynamics of a haemodynamic headache: A case report and literature review of headache secondary to flow inversion of the internal jugular vein.

BackgroundHaemodialysis arteriovenous fistulas have common local and regional complications, but are rarely associated with neurological symptoms.Case reportA 43-year-old woman presented with short acute episodes of unilateral, non-throbbing, severe headache, vertigo and left lateropulsion. She had undergone renal transplantation and had a still-functioning left brachial arteriovenous fistula. No abnormality was detected on neurological examination or on brain parenchymal imaging. Colour Doppler ultrasonography showed a subclavian steal syndrome of the left vertebral artery and reversed flow in the left internal jugular vein. Ligation of the arteriovenous fistula had to be delayed as a result of renal graft dysfunction. Six months later she developed a headache attributed to intracranial hypertension. All symptoms subsided after ligation of the arteriovenous fistula.Literature reviewWe identified 16 case reports of central neurological complications attributed to haemodialysis brachial fistulas. Headache ...