Abstract
This is a case of a 65-year-old female patient who presented with acute signs and symptoms of bilateral orbital congestion and impaired ocular movements. Diagnostic work-up revealed an indirect (i.e., dūral) carotid cavernous sinus fistula draining primarily into both superior ophthalmic veins (SOV), with the left SOV showing marked ectasia. Endovascular treatment was performed via the left superior ophthalmic vein after retrograde catheterization via the left facial vein. The affected cavernous sinus was occluded with detachable coils, leading to complete obliteration of the fistula and marked improvement of the clinical symptoms. Endovascular management of dural arteriovenous fistulae located at the cavernous sinus is the main topic of this chapter.
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References
Barrow DL, Spector RH, Braun IF, Landman JA, Tindall SC, Tindall GT. Classification and treatment of spontaneous carotid-cavernous sinus fistulas. J Neurosurg. 1985;62(2):248–56. https://doi.org/10.3171/jns.1985.62.2.0248.
Castro-Afonso LH, Trivelato FP, Rezende MT, Ulhôa AC, Nakiri GS, Monsignore LM, Abud DG. The routes for embolization of dural carotid cavernous fistulas when the endovascular approach is indicated as a first-line strategy. Interv Neuroradiol. 2019;25(1):66–70. https://doi.org/10.1177/1591019918796493.
Ellis JA, Goldstein H, Connolly ES Jr, Meyers PM. Carotid-cavernous fistulas. Neurosurg Focus. 2012;32(5):E9. https://doi.org/10.3171/2012.2.FOCUS1223.
Ghosh R, Al Saiegh F, Mahtabfar A, Mouchtouris N, Khanna O, Sweid A, Chalouhi N, Lebovitz J, Tjoumakaris S, Gooch MR, Rosenwasser RH, Jabbour PM. Burr hole-assisted direct transsylvian venous catheterization for carotid-cavernous fistula embolization: a case report. Oper Neurosurg (Hagerstown). 2020:opz394. https://doi.org/10.1093/ons/opz394.
Heiroth HJ, Turowski B, Etminan N, Steiger HJ, Hänggi D. Coiling of a carotid cavernous sinus fistula via microsurgical venotomy: recommendation of a combined neurosurgical and endovascular approach. J Neurointerv Surg. 2013;5(2):e7. https://doi.org/10.1136/neurintsurg-2011-010209.
Henderson AD, Miller NR. Carotid-cavernous fistula: current concepts in aetiology, investigation, and management. Eye (Lond). 2018;32(2):164–72. https://doi.org/10.1038/eye.2017.240.
Mouchtouris N, Lang MJ, Stefanelli A, Hirsch W, Tjoumakaris S, Gooch MR, Rosenwasser R, Jabbour PM. Cavernous-carotid fistula presenting with intracerebral hemorrhage in the absence of ocular symptoms. World Neurosurg. 2020;137:338–40. https://doi.org/10.1016/j.wneu.2020.01.228.
Ringer AJ, Salud L, Tomsick TA. Carotid cavernous fistulas: anatomy, classification, and treatment. Neurosurg Clin N Am. 2005;16(2):279–95. https://doi.org/10.1016/j.nec.2004.08.004. viii.
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AlMatter, M., Wirth, S., Kuršumovic, A., Ritz, R. (2020). Dural Carotid Cavernous Sinus Fistula: Endovascular Transvenous Treatment of an Indirect Carotid Cavernous Sinus Fistula via a Retrograde Approach to the Superior Ophthalmic Vein. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Arteriovenous Malformations and Fistulas Casebook. Springer, Cham. https://doi.org/10.1007/978-3-030-51200-2_3-1
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DOI: https://doi.org/10.1007/978-3-030-51200-2_3-1
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