Endovascular Management of Carotid Cavernous Fistulas

Author(s):  
Gerard M. Debrun
2010 ◽  
Vol 28 (5) ◽  
pp. E6 ◽  
Author(s):  
Sudhakar Vadivelu ◽  
Randy Scott Bell ◽  
Ben Crandall ◽  
Tom DeGraba ◽  
Rocco A. Armonda

Blast-induced neurotrauma is a leading cause of military casualties. Its effects on cerebrovascular structures are not well understood. Vascular injury resulting from overpressure shock wave impact may have a delayed presentation and detection. The authors present the cases of 2 patients who sustained blast-induced craniofacial trauma and brain injury. Detection of a cervical dissection was delayed in one patient, and detection of carotid-cavernous fistulas was delayed in both patients. The authors report the successful obliteration of both the dissection and the carotidcavernous fistulas via an endovascular approach. Endovascular management provides both a reasonable and effective therapeutic option to blast-induced cerebrovascular injuries.


Author(s):  
Vladislav Miropolsky ◽  
Leodante B. da Costa ◽  
Thomas R. Marotta ◽  
Julian Spears

Objective:Dural arteriovenous fistulae (DAVF) of the hypoglossal canal region are rare lesions. We describe three cases of DAVF of the hypoglossal canal presenting with ocular symptoms and discuss the endovascular management options.Methods:Three consecutive patients with DAVF of the hypoglossal canal region presented with proptosis, chemosis and disturbances of extra-ocular mobility. Each patient was treated using a different endovascular approach, based on variations of the vascular access.Results:The cases and treatments are reviewed, with a literature review on the subject. Endovascular treatment, transvenous or trans-arterial was curative in all cases.Conclusion:DAVF of the hypoglossal canal region can present with ocular manifestations very similar to DAVF of the cavernous sinus or carotid-cavernous fistulas. Endovascular treatment is usually feasible and effective, but an understanding of the vascular anatomy and pathophysiology of the disease are of utmost importance when planning the approach.


1994 ◽  
Vol 5 (3) ◽  
pp. 485-495 ◽  
Author(s):  
Stanley L. Barnwell ◽  
Oisin R. O'Neill

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