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Traumatic anterior communicating artery pseudoaneurysm with cavernous sinus fistula

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Summary

A traumatic carotid-cavernous fistula and an intracranial pseudoaneurysm are uncommon but well-known complications of head trauma. A rare subtype of arteriovenous fistula may occur from a pseudoaneurysm of the anterior communicating artery (AcoA) instead of the internal carotid artery. We describe a patient with a traumatic pseudoaneurysm of the AcoA with a cavernous sinus fistula treated with endovascular treatment. A 68-year-old man presented with a severe head injury after a fall. Coronal view multiplanar reformatted images with contrast medium showed gradual expansion of the pseudoaneurysm of the AcoA and the enhanced area of the cavernous sinus. Five weeks after the injury, the patient had a subarachnoid hemorrhage. A cerebral angiogram showed a fistula between the pseudoaneurysm of the AcoA and the cavernous sinus. The AcoA, left anterior cerebral artery and part of the pseudoaneurysm were obliterated by coil embolization. A postoperative angiogram showed no flow through the pseudoaneurysm and the cavernous sinus fistula. A traumatic AcoA pseudoaneurysm with a cavernous sinus fistula may occur as an extremely rare complication of head injury.

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References

  1. Asari S, Nakamura S, Yamada O, Beck H, Sugatani H (1977) Traumatic aneurysm of peripheral cerebral arteries. Report of two cases. J Neurosurg 46:795–803

    Article  CAS  PubMed  Google Scholar 

  2. Buckingham MJ, Crone KR, Ball WS, Tomsick TA, Berger TS, Tew JM Jr (1988) Traumatic intracranial aneurysms in childhood: two cases and a review of the literature. Neurosurgery 22:398–408. doi:10.1097/00006123-198802000-00022

    Article  CAS  PubMed  Google Scholar 

  3. Fabian TS, Woody JD, Ciraulo DL, Lett ED, Phlegar RF, Barker DE, Burns RP (1999) Posttraumatic carotid cavernous fistula: frequency analysis of signs, symptoms, and disability outcomes after angiographic embolization. J Trauma 47:275–281. doi:10.1097/00005373-199908000-00009

    Article  CAS  PubMed  Google Scholar 

  4. Haddad FS, Haddad GF, Taha J (1991) Traumatic intracranial aneurysms caused by missiles: their presentation and management. Neurosurgery 28:1–7. doi:10.1097/00006123-199101000-00001

    Article  CAS  PubMed  Google Scholar 

  5. Lempert TE, Halbach VV, Higashida RT, Dowd CF, Urwin RW, Balousek PA, Hieshima GB (1998) Endovascular treatment of pseudoaneurysms with electrolytically detachable coils. AJNR Am J Neuroradiol 19:907–911

    CAS  PubMed  Google Scholar 

  6. Noterman J, Flament-Durand J, Hermanus N, Brotchi J (1985) Traumatic aneurysm of the anterior cerebral artery associated with a contralateral carotid-cavernous fistula: a case report. Neurosurgery 17:807–810. doi:10.1097/00006123-198511000-00014

    Article  CAS  PubMed  Google Scholar 

  7. Sakamoto S, Ohba S, Shibukawa M, Kiura Y, Okazaki T, Arita K, Kurisu K (2005) Staged bilateral vertebral artery occlusion for ruptured dissecting aneurysms of the basilar artery: a report of 2 cases. Surg Neurol 64:456–461. doi:10.1016/j.surneu.2005.01.021

    Article  PubMed  Google Scholar 

  8. Sakamoto S, Ohba S, Eguchi K, Shibukawa M, Kiura Y, Okazaki T, Kajihara Y, Arita K, Kurisu K (2005) Churg-Strauss syndrome presenting with subarachnoid hemorrhage from ruptured dissecting aneurysm of the intracranial vertebral artery. Clin Neurol Neurosurg 107:428–431. doi:10.1016/j.clineuro.2004.09.020

    Article  PubMed  Google Scholar 

  9. Siniluoto T, Seppänen S, Kuurne T, Wikholm G, Leinonen S, Svendsen P (1997) Transarterial embolization of a direct carotid cavernous fistula with Guglielmi detachable coils. AJNR Am J Neuroradiol 18:519–523

    CAS  PubMed  Google Scholar 

  10. Uzan M, Cantasdemir M, Seckin MS, Hanci M, Kocer N, Sarioglu AC, Islak C (1998) Traumatic intracranial carotid tree aneurysms. Neurosurgery 43:1314–1320. doi:10.1097/00006123-199812000-00024

    Article  CAS  PubMed  Google Scholar 

  11. Ventureyra EC, Higgins MJ (1994) Traumatic intracranial aneurysms in childhood and adolescence. Case reports and review of the literature. Childs Nerv Syst 10:361–379. doi:10.1007/BF00335125

    Article  CAS  PubMed  Google Scholar 

  12. Weaver KD, Ewend MG, Solander S (2003) Successful transarterial Guglielmi detachable coil embolization of posttraumatic posterior communicating artery-cavernous sinus fistula: technical note. Neurosurgery 52:458–460. doi:10.1227/01.NEU.0000043817.55770.F8

    Article  PubMed  Google Scholar 

  13. Yang TC, Lo YL, Huang YC, Yang ST (2007) Traumatic anterior cerebral artery aneurysm following blunt craniofacial trauma. Eur Neurol 58:239–245. doi:10.1159/000107970

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Shigeyuki Sakamoto, Masaaki Shibukawa, Yoshihiro Kiura, Ryu Tsumura, Takahito Okazaki, Toshinori Matsushige & Kaoru Kurisu

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  1. Shigeyuki Sakamoto
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  2. Masaaki Shibukawa
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  3. Yoshihiro Kiura
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  4. Ryu Tsumura
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  5. Takahito Okazaki
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  6. Toshinori Matsushige
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  7. Kaoru Kurisu
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Correspondence to Shigeyuki Sakamoto.

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Sakamoto, S., Shibukawa, M., Kiura, Y. et al. Traumatic anterior communicating artery pseudoaneurysm with cavernous sinus fistula. Acta Neurochir 151, 1531–1535 (2009). https://doi.org/10.1007/s00701-009-0285-6

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  • DOI: https://doi.org/10.1007/s00701-009-0285-6

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