Summary
A case is reported of a 53-year-old woman who was hit by a bullet which penetrated the skull base and caused a left carotid-cavernous fistula of the direct type and a pseudoaneurysmal dilation of the high cervical portion of the left internal carotid artery. The fistula was succesfully embolized by positioning a balloon into the fistula itself by means of the Debrun technique: unexpectedly the size of the pseudoaneurysm decreased after the embolization; the possible explanations for this event are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Rich NM, Hobson RW, Collins GJ (1975) Traumatic arteriovenous fistulas and false aneurysms: a review of 558 lesions. Surgery 78: 817–828
North CM, Ahmadi J, Segall HD, Zee CS (1986) Penetrating vascular injuries of the face and neck: clinical and angiographic correlation. AJNR 7: 855–859
Shoung HM, Sichez JP, Pertuiset B (1985) The early prognosis of craniocerebral gunshot wounds in civilian practice as an aid to the choice of treatment. Acta Neurochir 74: 27–30
Köning A, Herrmann HD (1985) Spontaneous healing of a carotid cavernous fistula caused by a gunshot. Neurochirurgia 28: 22–24
Pelofsky S, Fisher RG, Stough DR (1972) Carotid cavernous fistula with spontaneous closure of the internal carotid artery. J Trauma 12: 1003–1004
Debrun GM, Lacour P, Caron JP, Hurt M, Comoy J, Reravel Y (1978) Detachable balloon techniques in treatment of cerebral vascular lesions. J Neurosurg 49: 635–649
Peeters FLM, Kröger R (1979) Dural and direct cavernous sinus fistulas. AJR 132: 599–606
Hamby WB (1966) Carotid cavernous fistula. Thomas, Springfield, Illinois
Hosobuchi Y (1975) Electrothrombosis of carotid cavernous fistulas. J Neurosurg 42: 76–85
Mullan S (1979) Treatment of carotid cavernous fistulas by cavernous sinus occlusion. J Neurosurg 50: 131–135
Manelfe C, Berenstein A (1980) Treatment of carotid cavernous fistulas by venous approach. Report of one case. J Neuroradiol 7: 13–16
Davis JM, Zimmerman RA (1983) Injury of the carotid and vertebral arteries. Neuroradiology 25: 58–69
Beall AC, Shirkey AL, De Bakey ME (1963) Penetrating wounds of the carotid arteries. J Trauma 3: 276–287
Busuttil RW, Davidson RK, Foley KT, Livesay JT, Barker WF (1980) Selective management of extracranial carotid artery aneurysms. Am J Surg 140: 85–91
Flemming JFR, Petrie D (1986) Traumatic thrombosis of the internal carotid artery with delayed hemiplegia. Can J Surg 11: 166–172
Rhodes EL, Stanley JC, Hoffman GL, Cronenwett JL, Fry WJ (1976) Aneurysms of extracranial carotid arteries. Arch Surg 111: 339–343
Sundt TM, Pearson BW, Piepgras DG, Houser OW, Mokri B (1986) Surgical management of aneurysms of the distal extracranial internal carotid artery. J Neurosurg 64: 169–182
Batzdorf U, Bentson JR, Machleder HI (1979) Blunt trauma to the high cervical carotid artery. Neurosurgery 5: 195–201
Takahashi M, Nakano Y (1980) Magnification angiography of dural carotid-cavernous sinus fistulae. With emphasis on clinical and angiographic evolution. Neuroradiology 19: 249–256
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mori, S., Feliciani, M., Guglielmi, G. et al. Regression of an internal carotid artery pseudoaneurysm after therapeutic embolization of a post-traumatic carotid-cavernous fistula secondary to gunshot injury. Neuroradiology 32, 226–228 (1990). https://doi.org/10.1007/BF00589117
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00589117