Long-Standing Traumatic Carotid-Cavernous Fistula with Dural Arteriovenous Fistula - Case Report -

뇌경막 동정맥루를 동반한 장기간 지속된 외상성 경동맥-해면정맥동루 - 증례보고 -

  • Park, Kyung Bum (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Park, In Sung (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Kim, Joon Soo (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Kim, Ki Jeong (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Hwang, Soo Hyun (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Kim, Eun-Sang (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Jung, Jin-Myung (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Han, Jong Woo (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Kim, Jae Hyung (Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience)
  • 박경범 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 박인성 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 김준수 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 김기정 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 황수현 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 김은상 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 정진명 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 한종우 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 김재형 (경상대학교 의과대학 진단방사선과학교실)
  • Received : 2001.06.21
  • Accepted : 2001.12.10
  • Published : 2001.12.31

Abstract

Traumatic carotid-cavernous fistula is a rare complication of moderate to severe head injury. For the treatment of carotid-cavernous fistula, detachable balloon occlusion is the best method of choice. A 26 year old male patient was hurt with a left periorbital penetrating injury 20 years ago, and then left side exophthalmos, bruit and right hemiparesis developed 10 years later. We experienced the very rare case of direct carotidcavernous fistula with cavernous dural arteriovenous fistula. Brain MRIs and cerebral angiograms revealed that direct carotid-cavernous fistula was accompanied by cavernous dural arteriovenous fistula due to longstanding venous hypertension and development of collateral circulation. Detachable balloon occlusion and surgical internal carotid artery ligation were not enough to occlude fistular flow, so cavernous dural arteriovenous fistula embolization was necessary. The authors present a case of long-standing traumatic carotid-cavernous fistula with cavernous dural arteriovenous fistula, with review of the literature.

Keywords