Posttraumatic Carotid-cavernous fistula Combined with Intracavernous False Aneurysm.
- Author:
Jong Won CHOE
1
;
Kum WHANG
;
Hyun Ho JUNG
;
Yong Pyo HAN
;
Hun Joo KIM
;
Soon Ki HONG
;
Chul HU
;
Jhin Soo PYEN
Author Information
1. Department of Neurosurgery, Yonsei University, Wonju college of medicine. whangkum@yonsei.ac.kr
- Publication Type:Case Report
- Keywords:
Carotid-cavernous fistula;
Pseudoaneurysm;
Endovascular;
Balloon test occlusion
- MeSH:
Aneurysm;
Aneurysm, False*;
Angiography;
Carotid Artery, Internal;
Cavernous Sinus;
Collateral Circulation;
Fistula*;
Follow-Up Studies;
Humans;
Neurologic Examination;
Skull Base;
Veins;
Young Adult
- From:Korean Journal of Cerebrovascular Surgery
2007;9(3):216-220
- CountryRepublic of Korea
- Language:English
-
Abstract:
Posttraumatic high-flow communications between the intracavernous internal carotid artery (ICA) and the cavernous sinus may give rise to two different pathological entities. A connection from the intracavernous ICA system can theoretically connect with two different structures; the vein of the plexus (CCF) or the perivascular bare spaces between the veins (pseudoaneurysm). A CCF and a pseudoaneurysm can be present in the same patient. A 24-year-old man was admitted to our hospital due to sudden mental deterioration. Carotid angiography revealed a CCF, which had occurred after a trauma 5 years earlier, associated with left visual disturbance and skull base fractures. The treatment of choice was permanent coil occlusion of the intracavernous ICA at the level of the lesion. The collateral circulation was evaluated before the endovascular treatment using a balloon test occlusion (BTO). During the BTO, adequate collateral circulation was defined as symmetric angiographic filling of both hemispheres. A continuous neurological examination was performed during the procedure. The follow-up angiography showed a persistent aneurysm occlusion. We report our experience of the successful endovascular treatment of combined lesions with a review of the relevant literature.
