1/124. Management of a rare complication of endovascular treatment of direct carotid cavernous fistula.A 30-year-old woman with direct carotid cavernous fistula underwent endovascular treatment with detachable balloons via a transarterial route. The patient returned with diplopia 1 year after therapy. On cranial MR imaging, one of the balloons was detected in the proximal portion of the superior ophthalmic vein and was deflated percutaneously with a 22-gauge Chiba needle under CT guidance. The patient's symptoms resolved after balloon deflation. This case report presents a unique complication of endovascular treatment of direct carotid cavernous fistula and its management.- - - - - - - - - - ranking = 1keywords = carotid (Clic here for more details about this article) |
2/124. Direct carotid-cavernous sinus fistula due to ruptured intracavernous aneurysm treated with electrodetachable coils--case report.A 66-year-old female developed exophthalmos, impaired visual acuity (perception of light), and diplopia one day after sudden onset of headache. Neurological examination revealed proptosis, chemosis, impaired vision, and ophthalmoplegia. Carotid angiography showed direct carotid-cavernous sinus fistula concomitant with an intracavernous aneurysm on the right side. Intraaneurysmal embolization using the Guglielmi detachable coils (GDCs) via the transarterial route was performed and complete occlusion of the fistula successfully achieved. The neurological deficits resolved completely by 6 months after embolization. Intraaneurysmal GDC embolization via the transarterial route may be an alternative for the treatment of direct carotid-cavernous sinus fistula due to rupture of intracavernous aneurysm.- - - - - - - - - - ranking = 1keywords = carotid (Clic here for more details about this article) |
3/124. Marked regional heterogeneity in venous oxygen saturation in severe head injury studied by superselective intracranial venous sampling: case report.OBJECTIVE: Continuous monitoring of jugular venous oxygen saturation (SjvO2) is useful in the management of severe head injury. Abnormally high SjvO2 values can be caused by increased cerebral blood flow, decreased cerebral metabolism, brain death, contamination from extracerebral venous blood, or traumatic arteriovenous fistula. CLINICAL PRESENTATION: A 20-year-old man with severe head injury was diagnosed to have a traumatic dural carotid-cavernous sinus fistula on the day of trauma. Continuous left SjvO2 monitoring from Days 4 to 12 revealed oxygen saturation ranging between 85 and 98%. INTERVENTION: Superselective intracranial and extracranial venous sampling on Day 5 demonstrated marked regional heterogeneity in venous oxygen saturation as follows: superior sagittal sinus, 95 to 97%; straight sinus, 88%; right transverse sinus, 94%; left transverse sinus, 74%; right SjvO2, 95%; left SjvO2, 89%; the basilar plexus, 99%; right internal jugular vein, 98%; the left internal jugular vein, 94%. Extremely high oxygen saturation in the superior sagittal sinus and basilar plexus was attributed to severe brain damage and carotid-cavernous sinus fistula, respectively. CONCLUSION: Although jugular bulb oximetry is useful in the management of severe head injury, high oxygen saturation values should be interpreted with caution because they cannot show the intracranial heterogeneity of venous oxygen saturation.- - - - - - - - - - ranking = 0.33333333333333keywords = carotid (Clic here for more details about this article) |
4/124. Traumatic aneurysm and carotid-cavernous fistula following transsphenoidal approach to a pituitary adenoma: treatment by transcranial operation.A 39-year old woman presented with galactorrhoea. magnetic resonance imaging revealed an intrasellar tumour. During transsphenoidal surgery to remove the tumour, arterial bleeding occurred from the right internal carotid artery (ICA). The bleeding was stopped by packing with Surgicel. The operation was discontinued at this point and the intrasellar tumour was not removed. Four-vessel angiography was performed on the third day after the operation, revealing a traumatic (false) ICA aneurysm and a low-flow carotid-cavernous fistula (CCF) on the right side. The patient did not have any neurological deficit, and was re-operated on transcranially. Both the traumatic ICA aneurysm and the CCF were excluded from the circulation by a Sundt-Kees cuff clip. The patency of the ICA was preserved.- - - - - - - - - - ranking = 1.054291240798keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
5/124. Direct carotid cavernous fistula after submucous resection of the nasal septum.A carotid cavernous fistula (CCF) is an abnormal arteriovenous anastomosis between the carotid artery and the cavernous sinus. Etiologies of this condition reported in the literature so far include facial trauma, rupture of an intracavernous aneurysm of the carotid artery, Ehler-Danlos syndrome and fibromuscular dysplasia of the cerebral arteries. Such fistulae were reported as complications of rhinoplasty, transsphenoidal surgery, embolization of cavernous sinus meningioma, and rhinocerebral mucormycosis. CCF may also occur spontaneously in children or as a congenital malformation. However, to our knowledge, submucous resection of the nasal septum has not been reported before to cause direct carotid-cavernous fistula. CT and angiographic findings are presented and a review of the literature for reported causes of CCF is made as well as a brief discussion of the possible pathophysiology.- - - - - - - - - - ranking = 1.4419158149293keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
6/124. Spontaneous resolution of bilateral traumatic carotid cavernous fistulas and development of trans-sellar intercarotid vascular communication: case report.BACKGROUND: Bilateral carotid cavernous fistulas may complicate head injury. Spontaneous resolution of post-traumatic direct carotid cavernous fistula is rare. CASE DESCRIPTION We present a case of a 42-year-old female who developed post-traumatic high flow bilateral carotid cavernous fistulas with cortical and deep venous drainage, who had a spontaneous resolution with thrombosis of the cavernous sinus outlets bilaterally and development of a trans-sellar intercarotid vascular communication. To our knowledge this is the first reported case in the literature describing such a phenomenon. CONCLUSION Bilateral direct carotid cavernous fistulas may undergo spontaneous resolution and form a benign trans-sellar intercarotid vascular communication.- - - - - - - - - - ranking = 2.3333333333333keywords = carotid (Clic here for more details about this article) |
7/124. Direct caroticocavernous fistula and traumatic dissection of the ipsilateral internal carotid artery: endovascular treatment.After severe craniocerebral trauma a 14-year-old boy developed progressive exophthalmos with venous congestion and chemosis, due to a direct caroticocavernous fistula. Angiography revealed traumatic occlusion of the ipsilateral internal carotid artery and absence of the inferior petrosal sinus. After failure of an approach via the anterior and posterior communicating arteries, the cavernous sinus was successfully catheterised through the occluded internal carotid artery, and embolisation performed with coils.- - - - - - - - - - ranking = 1.325747444788keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
8/124. Transvenous embolization of carotid-cavernous sinus fistula associated with a primitive trigeminal artery--case report.A 58-year-old female presented with right conjunctival chemosis and right abducens nerve paresis. cerebral angiography demonstrated a right carotid-cavernous sinus fistula associated with persistent primitive trigeminal artery. The fistula was treated by introducing detachable coils through the transvenous approach, as the detachable balloon was not available. Follow-up angiography performed 14 days after the embolization revealed complete disappearance of the carotid-cavernous sinus fistula due to thrombosis, which was presumably accelerated by the coils. Transvenous coil embolization should be considered as an alternative treatment for high-flow carotid-cavernous sinus fistula, but only if transarterial balloon embolization is not successful or unavailable.- - - - - - - - - - ranking = 1.170907686807keywords = carotid, artery (Clic here for more details about this article) |
9/124. Carotid-cavernous fistulas: diagnosis with spiral CT angiography.Four cases in which the diagnosis of carotid-cavernous fistula was made by using CT angiography are illustrated. The diagnosis was confirmed by digital subtraction angiography in all four instances. To our knowledge, this is the first report of the CT angiographic appearance of carotid-cavernous fistulas.- - - - - - - - - - ranking = 0.33333333333333keywords = carotid (Clic here for more details about this article) |
10/124. CT-revealed choroidal effusions as a sign of carotid cavernous fistula.Choroidal effusions may appear as subtle abnormalities on CT scans. Recognition of choroidal effusions, however, is critical because they may be an early sign of ocular pathologic abnormality. After detection, the various causes of choroidal effusions, such as carotid cavernous fistulas, ocular hypotony, tumors, and inflammatory conditions, should be considered.- - - - - - - - - - ranking = 0.83333333333333keywords = carotid (Clic here for more details about this article) |
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