Recurrent Carotid Cavernous Fistula Originating from a Giant Cerebral Aneurysm after Placement of a Covered Stent.
10.7461/jcen.2016.18.3.306
- Author:
Jung Wook BAEK
1
;
Sung Tae KIM
;
Young Seo LEE
;
Young Gyun JEONG
;
Hae Woong JEONG
;
Jin Wook BAEK
;
Jung Hwa SEO
Author Information
1. Department of Neurosurgery, Busan Paik Hospital, Inje University, School of Medicine, Busan, Korea. kimst015@hanmail.net
- Publication Type:Case Report
- Keywords:
Carotid-cavernous sinus fistula;
Intracranial aneurysm;
Stents
- MeSH:
Aneurysm;
Carotid Artery, Internal;
Carotid-Cavernous Sinus Fistula;
Cerebral Angiography;
Cerebral Arteries;
Endoleak;
Exophthalmos;
Female;
Fistula*;
Headache;
Humans;
Intracranial Aneurysm*;
Middle Aged;
Neck;
Rupture;
Stents*
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2016;18(3):306-314
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report the case of a recurrent carotid cavernous fistula (CCF) originating from a giant cerebral aneurysm (GCA) after placement of a covered stent. A 47-year-old woman presented with sudden onset of severe headache, and left-sided exophthalmos and ptosis. Cerebral angiography revealed a CCF caused by rupture of a GCA in the cavernous segment of the left internal carotid artery. Two covered stents were placed at the neck of the aneurysm. The neurological symptoms improved at first, but were aggravated in the 6 months following the treatment. Contrast agent endoleak was seen in the distal area of the stent. Even though additional treatments were attempted via an endovascular approach, the CCF could not be cured. However, after trapping the aneurysm using coils and performing superficial temporal artery-middle cerebral artery bypass, the neurological symptoms improved. In cases of recurrent CCF originating from a GCA after placement of a covered stent, it is possible to treat the CCF by endovascular trapping and surgical bypass.
