Delayed Pontomesencephalic and Cervical Cord Venous Drainage Followed by Contralateral Carotid-Cavernous Fistula after Craniofacial Fractures: A Case Report
10.5469euroint.2024.00318
- Author:
Steven TANDEAN
1
;
Harsan HARSAN
;
Andre Marolop Pangihutan SIAHAAN
;
Harley SEPTIAN
;
Alexander JOSETHANG
Author Information
1. Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Publication Type:Case Report
- From:Neurointervention
2024;19(3):185-189
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 24-year-old male was admitted with progressive cervical hypesthesia, tetraparesis, dyspnea, and a history of craniofacial fracture. Spinal magnetic resonance imaging (MRI) showed brainstem edema extending to the thoracic spine with multiple prominent perimedullary vascular structures. Cerebral digital-substraction angiography revealed Barrow type A carotid-cavernous fistula. Total occlusion with preservation of internal carotid artery flow was achieved using 1 detachable balloon and 6 coils. Postoperatively, immediate respiratory recovery, gradual extremities strength improvement, and right abducens nerve palsy were found. One month follow-up cervical MRI showed good recovery of spinal cord edema and perimedullary veins.
