Clinical Analysis of Traumatic Carotid-Cavernous Fistula.
- Author:
Boung Cheul BAE
1
;
Chang Hwa CHOI
;
Young Woo LEE
Author Information
1. Department of Neurosurgery, School of Medicine, Pusan National University, Pusan, Korea.
- Publication Type:Original Article
- Keywords:
Traumatic carotid-cavernous fistula;
Direct obliteration;
Carotid ligation;
Detachable balloon technique
- MeSH:
Carotid Artery, External;
Carotid Artery, Internal;
Craniocerebral Trauma;
Fistula*;
Ligation;
Skull Fractures
- From:Journal of Korean Neurosurgical Society
1996;25(10):2115-2121
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Traumatic carotid-cavernous fistula(CCF) is a rare complication of moderate to severe head injury. A series of 15 traumatic carotid-cavernous fistulas has been analyzed and 13 cases have been treated with 3 different methods:direct obliteration through pterional approach(5 cases), ligation of internal, common and external carotid artery in the neck(2 cases), occlusion of CCF with detachable balloon technique(6 cases). The remaining 2 cases were treated by conservative procedures. There were 12 cases(80%) with skull fractures, the majority of which(10 cases) had frontal vault and basal skull fractures. The results of each method were as follows:1) Among the 5 direct obliteration procedure groups, we got satisfactory results in only 2 cases(40%), and the other 2 cases needed additional instantaneous carotid trapping procedures, which corrected the fistula. Internal carotid artery patency was also preserved in 2 cases(40%). 2) Among the 2 cases of carotid trapping group, only 1 case(50%) improved to good. 3) Amo ng the detachable balloon group, 5 cases(83.3%) recovered to good or corrected. Carotid patency was preserved in 4 cases(67.7%). As a result, initial treatment modality of CCF should be detachable balloon technique because of good preservation of carotid patency, better result, simplicity, and safety compared with other operative methods.
