Manual compression of the ipsilateral carotid artery and jugular vein can help. This compression may damage the nerve function, which is to. Ctaguided outflowtargeted embolization of direct carotid cavernous fistula chihhsiang liao, md,1,2 wenhsien chen, md,4 nienchen liao, md,3 and yuangseng tsuei, md1,2,5 1chung shan caratico cavernous fistula patients with carotico cavernous fistula ccf present with a pulsatile swelling in the eye. Artery ica or external carotid artery eca and cavernous sinus cs fig. Classification and treatment of spontaneous carotidcavernous sinus.
Treatment of highflow carotid cavernous fistula using a. A carotidcavernous sinus fistula is an abnormal connection that forms between a carotid artery in your neck and the network of veins at the back of your eye. Dural cavernous sinus fistulas diagnosis and endovascular. Caroticocavernous fistula radiology reference article. Get a printable copy pdf file of the complete article 2. Caroticocavernous sinus fistulae ccfs result from abnormal communication. Direct highflow carotid cavernous fistula ccf may be associated with traumatic fracture of the skull base and the sphenoid bone, which produces a direct communication between the internal carotid artery ica and the cavernous sinus cs. Lirng jf, chang t, chen ss, guo wy, cheng cc, shen wc, lee ls. The aetiology of ophthalmoplegia in 15 patients with carotidcavernous sinus fistula is discussed, and the clinical findings are correlated with angiographic and orbital ct appearances. After closure of the fistula the majority of patients with generalised ophthalmoplegia recovered full ocular movements rapidly, while patients with an isolated abduction weakness required much longer to return. Endovascular treatment of carotid cavernous sinus fistula. Cortical venous drainage from the carotid cavernous fistula.
Carotidcavernous fistulas ccfs are vascular shunts allowing blood to flow from the carotid artery into the. A fistula can raise the pressure in your cavernous sinuses, which may compress the cranial nerves located around the cavernous sinuses. Embolization of carotid cavernous fistula by means of direct puncture through the superior orbital fissure. These may result from direct trauma, surgery, dural sinus thrombosis, or atherosclerosis or may occur spontaneously. A carotid cavernous fistula is an abnormal communication between the carotid artery and the venous system within the cavernous sinus. A carotid cavernous fistula is an abnormal connection between the internal or external carotid artery and the cavernous sinus. This separates the blood flow of the carotid arteries from that of the veins. Dural arteriovenous fistulas in the parasellar region. Reiwlta et al, 18 reported a patient who developed an arteriovenous fistula in the region of the territory of the external carotid artery with the fistulous connection arising at the origin of the middle meningeal artery from the pterygopalatine artery which was punctured because of the posterolateral direction of the needle emerging from the foramen ovale. The treatment modalities include conservative management, which consists of medical management and manual compression therapy. As a result, the blood can drain properly from the eyes.
Carotid cavernous fistula, transvenous embolization, superior ophthalmic vein, inferior petrosal. Pdf carotid cavernous fistula ccf is an abnormal communication. Type a are direct highflow shunts between the internal carotid artery and the cavernous sinus. But treatment success rates for these fistulas now approach 100 percent when the repairs are performed early by experienced. Ophthalmoplegia in carotid cavernous sinus fistula. The potentially sightrobbing vascular abnormality known as the carotid cavernous sinus fistula ccf can masquerade as conjunctivitis or other common ocular conditions, which diminishes the chance for a speedy diagnosis. Any information contained in this pdf file is automatically generated from digital. Pdf endovascular treatment of carotid cavernous sinus fistula. The clinical manifestation of ccf is related to the venous drainage pattern, which may lead to various. The main goal in the treatment of ccfs is to preserve. Cavernous sinus fistula treated through the transvenous approach.