scholarly journals Contralateral extensive cerebral hemorrhagic venous infarction caused by retrograde venous reflux into the opposite basal vein of Rosenthal in posttraumatic carotid-cavernous fistula: A case report and literature review

2018 ◽  
Vol 24 (5) ◽  
pp. 546-558 ◽  
Author(s):  
Prasert Iampreechakul ◽  
Adisak Tanpun ◽  
Punjama Lertbusayanukul ◽  
Somkiet Siriwimonmas
Keyword(s):  
Basal Ganglia ◽  
Magnetic Resonance ◽  
Endovascular Treatment ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Venous Reflux ◽  
Carotid Cavernous Fistula ◽  
Venous Infarction ◽  
Cavernous Fistula ◽  
Basal Vein Of Rosenthal

We describe a patient with traumatic carotid-cavernous fistula (CCF), subsequently developing contralateral extensive hemorrhagic venous infarction from retrograde venous reflux into the opposite basal vein of Rosenthal. A 54-year-old woman was involved in a motor vehicle accident and sustained severe traumatic brain injury. Two months later, she developed bilateral proptosis and audible bruit. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) of the brain demonstrated the right direct CCF. Fluid-attenuated inversion recovery (FLAIR) images showed a small hyperintense area at the left basal ganglia. Ten days later, she developed right-sided grade 2/5 hemiparesis, facial upper motor neuron weakness, and cognitive impairment. Follow-up MRI showed significant progression of hyperintensities involving the left-sided centrum semiovale, basal ganglia, thalamus, midbrain, pons, cerebellum, basal frontal, temporal lobes, especially subcortical white matter on FLAIR images, and multiple hypointense foci of hemorrhagic component on T2*-weighted gradient-echo images, representing hemorrhagic venous infarction. While waiting for embolization, she rapidly developed right hemiplegia and aphasia, and became somnolent. Under general anesthesia, emergency endovascular treatment was performed successfully to obliterate the fistula without surgical intervention. Five months after endovascular treatment, MRI and MRA confirmed no residual fistula and revealed nearly complete resolution of abnormal increased signal intensity. In the present case, the factors related to the presence of this rare condition were absence of the ipsilateral basal vein of Rosenthal (BVR), occlusion of posterior segment of the contralateral superior petrosal sinus, and a developed uncal vein with hypoplastic second and third segments of the contralateral BVR.

Traumatic carotid—cavernous fistula treated by combined transarterial and transvenous coil embolization and associated cavernous internal carotid artery dissection treated with stent placement

2003 ◽  
Vol 99 (3) ◽  
pp. 584-586 ◽  
Author(s):  
Süleyman Men ◽  
Halil Öztürk ◽  
Baki HekimoğLu ◽  
Zeki Şekerci
Keyword(s):  
Carotid Artery ◽  
Stent Placement ◽  
Coil Embolization ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula

✓ The authors report on a case in which a carotid—cavernous fistula and an associated cavernous—carotid dissection developed in a 48-year-old man following a motor vehicle accident. The fistula was treated with coil embolization via a combined transarterial—transvenous approach. The dissected carotid artery segment was treated with a balloon-expandable stent, which restored normal caliber and hemispheric flow. There was no recurrence of the fistula and the postoperative wide patency of the carotid artery indicates that stent placement is an effective method of treating traumatic intracranial artery dissections.

Extensive basal ganglia edema caused by a traumatic carotid-cavernous fistula: a rare presentation related to a basal vein of Rosenthal anatomical variation

2014 ◽  
Vol 121 (1) ◽  
pp. 63-66 ◽  
Author(s):  
Isabelle Ract ◽  
Aurélie Drier ◽  
Delphine Leclercq ◽  
Nader Sourour ◽  
Joseph Gabrieli ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Vasogenic Edema ◽  
Anatomical Variation ◽  
Brain Mri ◽  
Venous Congestion ◽  
Carotid Cavernous Fistula ◽  
Orbital Trauma ◽  
Rare Presentation ◽  
Cavernous Fistula ◽  
Basal Vein Of Rosenthal

The authors report a very rare presentation of traumatic carotid-cavernous fistula (CCF) with extensive edema of the basal ganglia and brainstem because of an anatomical variation of the basal vein of Rosenthal (BVR). A 45-year-old woman was admitted to the authors' institution for left hemiparesis, dysarthria, and a comatose state caused by right orbital trauma from a thin metal rod. Brain MRI showed a right CCF and vasogenic edema of the right side of the brainstem, right temporal lobe, and basal ganglia. Digital subtraction angiography confirmed a high-flow direct CCF and revealed a hypoplastic second segment of the BVR responsible for the hypertension in inferior striate veins and venous congestion. Endovascular treatment was performed on an emergency basis. One month after treatment, the patient's symptoms and MRI signal abnormalities almost totally disappeared. Basal ganglia and brainstem venous congestion may occur in traumatic CCF in cases of a hypoplastic or agenetic second segment of the BVR and may provoke emergency treatment.

Evaluation of cerebral oximetry during endovascular treatment of carotid-cavernous fistula

1997 ◽  
Author(s):  
Manuel Dujovny ◽  
Mukesh Misra ◽  
M. Serdar Alp ◽  
Gerard Debrun ◽  
F. T. Charbel ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Oximetry ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula

scholarly journals Comparison between different modalities of Endovascular treatment in Carotid Cavernous Fistula (CCF) and its short term outcome – Our Experience

2019 ◽  
Vol 8 (2) ◽  
pp. 68-76
Author(s):  
Mst Shamima Sultana ◽  
Md Shafiqul Islam ◽  
Md Sumon Rana ◽  
Kanij Fatema Ishrat Zahan Rifat ◽  
Md Abul Kalam Azad ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Carotid Cavernous Fistula ◽  
Short Term ◽  
Term Outcome ◽  
Invasive Approach ◽  
Cavernous Fistula ◽  
Short Term Outcome ◽  
Choice Of Treatment ◽  
Glue Embolization ◽  
Carotid Cavernous Fistulas

Introduction: Endovascular treatment offers different technique (Balloon assisted coiling / simple coiling, glue embolization) to treat Carotid Cavernous Fistula (CCF). This less invasive approach avoids morbidity and residual fistulas. The choice of treatment depends on the anatomy of the fistulas and cost effectiveness. Objective: To describe different endovascular treatment option of Carotid Cavernous fistulas (CCF), its short term outcome (clinical and angiographical) and to compare between trans-venous coiling and trans-arterial balloon assisted sinus coiling. Method: We have treated nine (9) cases of CCF during a period of three years. Out of them eight patients had direct CCF and one had indirect CCF. In two patients simple coiling done through trans-venous route and in another three patients through trans-arterial route. Balloon assisted coiling through trans-arterial route done in three patients. In two patients trans-arterial glue embolization was done. Results: Successful obliteration of fistula was achieved in all cases. Vision was improved in eight (8) patients. Postoperatively some proptosis remains in two patients. In one patient there was reappearance of proptosis two months after treatment, then balloon assisted coiling was done. One patient died from complication of glue (NBCA). Conclusion: Endovascular treatment is the mainstay of treatment in CCF. Trans-venous is the treatment of choice but recently balloon assisted sinus coiling through trans-arterial route is adopted. Bang. J Neurosurgery 2019; 8(2): 68-76

scholarly journals Endovascular Treatment in an Unusual Case of Direct Carotid Cavernous Fistula

2014 ◽  
Vol 27 (2) ◽  
pp. 207-212 ◽  
Author(s):  
Rajendra Gajanan Chavan ◽  
Ravindra Bhimrao Kamble ◽  
Vivek Bonde
Keyword(s):  
Endovascular Treatment ◽  
Unusual Case ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Direct Carotid Cavernous Fistula

Overheated and melted intracranial pressure transducer as cause of thermal brain injury during magnetic resonance imaging

2012 ◽  
Vol 117 (6) ◽  
pp. 1100-1109 ◽  
Author(s):  
Reiichiro Tanaka ◽  
Tetsuya Yumoto ◽  
Naoki Shiba ◽  
Motohisa Okawa ◽  
Takao Yasuhara ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Injury ◽  
Magnetic Resonance ◽  
Intracranial Pressure ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Temporal Lobectomy ◽  
Resonance Imaging ◽  
Left Frontal Lobe ◽  
Strict Adherence

Magnetic resonance imaging is used with increasing frequency to provide accurate clinical information in cases of acute brain injury, and it is important to ensure that intracranial pressure (ICP) monitoring devices are both safe and accurate inside the MRI suite. A rare case of thermal brain injury during MRI associated with an overheated ICP transducer is reported. This 20-year-old man had sustained a severe contusion of the right temporal and parietal lobes during a motor vehicle accident. An MR-compatible ICP transducer was placed in the left frontal lobe. The patient was treated with therapeutic hypothermia, barbiturate therapy, partial right temporal lobectomy, and decompressive craniectomy. Immediately after MRI examination on hospital Day 6, the ICP monitor was found to have stopped working, and the transducer was subsequently removed. The patient developed meningitis after this event, and repeat MRI revealed additional brain injury deep in the white matter on the left side, at the location of the ICP transducer. It is suspected that this new injury was caused by heating due to the radiofrequency radiation used in MRI because it was ascertained that the tip of the transducer had been melted and scorched. Scanning conditions—including configuration of the transducer, MRI parameters such as the type of radiofrequency coil, and the specific absorption rate limit—deviated from the manufacturer's recommendations. In cooperation with the manufacturer, the authors developed a precautionary tag describing guidelines for safe MR scanning to attach to the display unit of the product. Strict adherence to the manufacturer's guidelines is very important for preventing serious complications in patients with ICP monitors undergoing MRI examinations.

Sign in / Sign up

Export Citation Format

Share Document