Summary
25 cases of carotid-cavernous fistulae (CCF) who underwent radiosurgery with a conventional gamma source from 1977 to 1992 are reported. 22 were low-flow, spontaneous CCFs and 3 were high flow fistulae which had undergone a previous trApplng. The total dose delivered was 30 to 40 Gy. 91% to patients with low-flow CCF cured after radiosurgery in a mean time of 7.5 months, presenting improvent in a mean time of 2.3 months. Only one of the high-flow fistulae was cured. Follow-up period ranged between 14 years and 15 months (mean: 50 months). No recurrence was recorded in any case. While intravascular embolotherapy is the treatment of choice for high-flow fistulae, stereotactic radiosurgery may be the elective treatment for low-flow CCF.
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Barcia-Salorio JL, Hernández G, Broseta J, et al (1979) Radiosurgical treatment of a carotid-cavernous fistula. Case report. In: Szikla G (ed) Stereotactic cerebral irradiation. Inserm symposium no 12. Holland biomedical press, Amsterdam, pp 251–256
Barcia-Salorio JL, Hernández G, Broseta J, et al (1982) Radiosurgical treatment of carotid-cavernous fistulae. Appl Neurophysiol 45: 520–522
Barcia-Salorio JL, Soler F, Hernández G, et al (1992) Radiosurgical treatment of low flow carotid-cavernous, fistulae. Acta Neurochir (Wien) [suppl] 52: 93–95
Barrow DL, Spector RH, Braun IF, et al (1985) Classification and treatment of spontaneous carotid-cavernous sinus fistulas. J Neurosurg 62: 248–256
Bitoh S, Hasegawa H, Fugiwara M, et al (1982) Irradiation of spontaneous carotid-cavernous fistulae. Surg Neurol 17: 282–286
Debrun GF, Vifiuela F, Fox AJ, et al (1988) Indications for treatment and classification of 132 carotid-cavernous fistulae. Neurosurgery 22: 285–289
Fabrikant JI, Lyman JT, Hosobuchi Y (1984) Stereotactic heavy-ion bragg peak radiosurgery for intracranial vascular disorders: method for treatment of deep arteriovenous malformations. J Radiol 57: 479–490.
Fajardo LF, Berthrong M (1988) Vascular lesions following radiation. Pathol Ann. 23: 297–330
Halbach VV, Higashida RT, Hieshima GM, et al (1987) Dural fistulas involving the cavernous sinus: results of treatment in 30 patients. Radiology 163: 437–442
Handa H (1984) Management of spontaneous carotid-cavernous fistulae. Neurologia Col 8: 46–49
Joanes V, Barcia-Salorio JL, Ciudad J, et al (1991) Narrow- bram gamma irradiation in stereotactic radiosurgery for arteriovenous fistulae. Research in Surgery 3: 67–73
Lasjaunias P, Berenstein A (1987) Surgical neuroangiography, Vol II. Endovascular treatment of craniofacial lesions. Springer Berlin Heidelberg New York Tokyo
Parkinson D (1965) A surgical approach to the cavernous portion of the carotid artery. Anatomical studies and case report. J Neurosurg 23: 474–483
Pierot L, Poisson M, Jason M, et al (1992) Treatment of type D dural carotid-cavernous fistula by embolization followed by irradiation. Neuroradiology 34: 77–80
Steiner L, Leksell L, Greitz T, et al (1972) Stereotaxic radiosurgery for cerebral arteriovenous malformations. Acta Chir Scand 138: 459–464
Taptas JN (1963) Arteriovenous aneurysm in pulsating exophtalmos: a new conception of the mechanism, in: Excerpta Medica International Congress Series 60. Excerpta Medica, Amsterdam, pp 98–99
Viñuela F, Fox AJ, DeBrun GM, et al (1984) Spontaneous carotid-cavernous fistulas: clinical radiological and therapeutic considerations. J Neurosurg 60: 976–984
Yamada F, Fukuda S, Matsumoto K, et al (1984) Effect of radiotherapy on dural arteriovenous malformations. Neurol Med Chir 24: 591–599
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Barcia-Salorio, J.L., Soler, F., Barcia, J.A., Hernández, G. (1994). Radiosurgery of Carotid-Cavernous Fistulae. In: Lindquist, C., Kondziolka, D., Loeffler, J.S. (eds) Advances in Radiosurgery. Acta Neurochirurgica Supplementum, vol 62. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9371-6_3
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