• Title/Summary/Keyword: Traumatic direct carotid-cavernous fistula

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Long-Standing Traumatic Carotid-Cavernous Fistula with Dural Arteriovenous Fistula - Case Report - (뇌경막 동정맥루를 동반한 장기간 지속된 외상성 경동맥-해면정맥동루 - 증례보고 -)

  • Park, Kyung Bum;Park, In Sung;Kim, Joon Soo;Kim, Ki Jeong;Hwang, Soo Hyun;Kim, Eun-Sang;Jung, Jin-Myung;Han, Jong Woo;Kim, Jae Hyung
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.153-158
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    • 2001
  • 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.

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Spontaneous Regression of the Pseudoaneurysm Developed after Balloon Occlusion of the Direct Carotid-cavernous Fistula

  • Lee, Chae-Heuck;Kim, Myoung-Soo;Lee, Ghi-Jai
    • Journal of Korean Neurosurgical Society
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    • v.41 no.5
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    • pp.323-326
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    • 2007
  • Direct carotid-cavernous fistula [CCF] is a common post-traumatic disease. However, pseudoaneurysm formation after balloon occlusion is a rare complication. The author present such a case with review of the literature. A 26-year-old man involved in a motor vehicle accident as a driver. Only mild conjunctival injection and minimal exophthalmos on the right eye were noted after trauma. However, angiography revealed a direct CCF and dissection of the proximal intracranial internal carotid artery [ICA]. After first balloon occlusion of the CCF, the patient redeveloped fistula due to early deflation of the balloon. After the second balloon occlusion, pseudoaneurysm and diplopia were developed with the change of balloon position and shape. However, visual symptom spontaneously resolved and pseudoaneurysm was also decreased within 6 months after balloon occlusion.

Carotid Cavernous Sinus Fistula with Abducens Nerve Palsy after Le Fort I Osteotomy : A Case Report (상악골절단술 후 외전신경마비를 동반한 경동맥 해면정맥동루)

  • Lee, Won-Hak;Kim, Dong-Ryul;Hong, Kwang-Jin;Lee, Jeong-Gu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.2
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    • pp.243-248
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    • 2000
  • Carotid cavernous sinus fistula(CCSF) is an abnormal communication at the base of the skull between the internal carotid artery and the cavernous sinus. Fistula is almost associated with extensive facial trauma as a result of direct or indirect forces. Most fistulas of traumatic origin develop as a result of fractures through the base of the skull, which cause the laceration of the internal carotid artery near the cavernous sinus. The signs and symptoms of CCSF are pulsating exophthalmosis, orbital headache, pain, orbital or frontal bruit, loss of visual acuity, diplopia and ophthalmoplegia. Angiography reveals a definite CCSF and a detachable balloon embolization is known to be the treatment of choice. Even though carotid cavernous sinus fistula is an uncommon complication after orthognathic surgery, several cases of CCSF due to congenital anomalies, pre-existing aneurysms and abnormally thickened maxillary posterior wall have been reported in the literature. We have experienced a case of CCSF after Le Fort I osteotomy for maxillary advancement in skeletal class III patient and the cause, pathogenesis, diagnosis and treatment of this case.

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