Bilateral superior ophthalmic vein enlargement associated with diffuse cerebral swelling

1997 ◽  
Vol 86 (5) ◽  
pp. 893-897 ◽  
Author(s):  
Rohit K. Khanna ◽  
Christopher J. Pham ◽  
Ghaus M. Malik ◽  
Eric M. Spickler ◽  
Bharat Mehta ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Graves Disease ◽  
Retrograde Flow ◽  
Cavernous Sinus Thrombosis ◽  
Superior Ophthalmic Vein ◽  
Content Type ◽  
Carotid Cavernous Fistulas ◽  
Tomography Scanning ◽  
Fine Print

✓ Bilateral superior ophthalmic vein (SOV) enlargement has rarely been shown to occur in patients with septic and aseptic cavernous sinus thrombosis, Graves' disease due to obstruction of the SOV by enlarged extraocular muscles, or carotid—cavernous fistulas caused by retrograde flow. The authors describe 11 patients with bilateral SOV enlargement associated with cerebral swelling as detected by computerized tomography scanning. The bilaterally enlarged SOVs returned to a normal size following resolution of cerebral swelling and elevated intracranial pressure. To the authors' knowledge, this is the first report of bilateral SOV enlargement associated with diffuse cerebral swelling that subsequently resolved after treatment of the cerebral edema. The authors believe that the bilateral SOV enlargement was caused by mechanical cavernous sinus venous stagnation due to cerebral swelling, a syndrome that occurs more commonly than currently appreciated.

Management of carotid-cavernous fistulas by surgery combined with interventional radiology

1983 ◽  
Vol 59 (6) ◽  
pp. 1076-1081 ◽  
Author(s):  
Brian M. Tress ◽  
Kenneth R. Thomson ◽  
Geoffrey L. Klug ◽  
Roger R. B. Mee ◽  
Bruce Crawford
Keyword(s):  
Interventional Radiology ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Balloon Catheter ◽  
Superior Ophthalmic Vein ◽  
Detachable Balloon ◽  
Content Type ◽  
First Case ◽  
Carotid Cavernous Fistulas ◽  
Fine Print

✓ Two cases of carotid-cavernous fistulas were successfully treated by standard interventional radiology techniques after otherwise inaccessible vessels were surgically exposed. In the first case, an internal carotid artery (ICA), which had previously been ligated as part of an attempted surgical “entrapment” procedure, was recanalized to permit passage of a detachable balloon catheter to the fistula, resulting in its obliteration. In the second case, an enlarged superior ophthalmic vein was exposed and isolated to facilitate retrograde catheterization of the cavernous sinus and obliteration of a dural fistula between the ICA and the cavernous sinus by steel Gianturco coils. The methods and complications of both procedures are discussed.

Treatment of bilateral spontaneous dural carotid-cavernous fistulas by coils and sclerotherapy

1987 ◽  
Vol 66 (3) ◽  
pp. 468-470 ◽  
Author(s):  
Patrick Courtheoux ◽  
Daniel Labbe ◽  
Christian Hamel ◽  
Pierre-Joel Lecoq ◽  
Marcio Jahara ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Superior Ophthalmic Vein ◽  
Content Type ◽  
Steel Coils ◽  
Carotid Cavernous Fistulas ◽  
Fine Print

✓ A case of bilateral spontaneous carotid-cavernous fistulas producing increased intraocular pressure is reported. The fistulas lay between the meningeal branches of the internal carotid artery (ICA) and the cavernous sinus, but the ICA itself was not involved. Successful treatment was accomplished by the introduction of steel coils and a sclerotic liquid into the cavernous sinus via the distal superior ophthalmic vein.

Septic cavernous sinus thrombosis following transsphenoidal craniotomy

1996 ◽  
Vol 85 (5) ◽  
pp. 949-952 ◽  
Author(s):  
Federico Sadun ◽  
Steven E. Feldon ◽  
Martin H. Weiss ◽  
Mark D. Krieger
Keyword(s):  
Antibiotic Therapy ◽  
Cavernous Sinus ◽  
Late Onset ◽  
Sinus Thrombosis ◽  
Cavernous Sinus Thrombosis ◽  
Broad Spectrum Antibiotic ◽  
Abscess Drainage ◽  
Intravenous Antibiotic ◽  
Content Type ◽  
Fine Print

✓ The authors present a case of late-onset cavernous sinus thrombosis in a 74-year-old man who had undergone transsphenoidal craniotomy for a pituitary macroadenoma 9 weeks previously. The patient developed headache, rapidly progressive ophthalmoplegia, and signs of orbital congestion. After 2 days of ineffective broad spectrum antibiotic therapy he underwent a second transsphenoidal craniotomy for abscess drainage. Intraoperative cultures grew 4+ nonhemolytic Streptococcus, 4+ Staphylococcus coagulase negative, and 4+ Haemophilus influenzae. The patient was maintained on intravenous antibiotic therapy for the following 6 weeks, resulting in a complete clinical recovery. To the authors' knowledge, this is the first report of a septic cavernous sinus thrombosis following a transsphenoidal craniotomy.

Carotid-cavernous sinus thrombosis caused by Aspergillus fumigatus

1980 ◽  
Vol 52 (1) ◽  
pp. 120-125 ◽  
Author(s):  
Laligam N. Sekhar ◽  
Manuel Dujovny ◽  
Gutti R. Rao
Keyword(s):  
Aspergillus Fumigatus ◽  
Cavernous Sinus ◽  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Sinus Thrombosis ◽  
Sella Turcica ◽  
Cavernous Sinus Thrombosis ◽  
Content Type ◽  
The Central Nervous System ◽  
Fine Print

✓ A case is presented of Aspergillus fumigatus granuloma involving the sphenoid sinus, sella turcica, cavernous sinus, and the internal carotid artery. The diagnosis was established by a transsphenoidal biopsy. The infection proved difficult to treat and finally remitted after chemotherapy with a combination of amphotericin B, rifampin (rifampicin), and flucytosine (5-fluorocytosine). The spectrum of aspergillosis of the central nervous system is reviewed, and difficulties in treating this infection are considered.

Successful surgical treatment of bilateral carotid-cavernous fistulas

1975 ◽  
Vol 43 (3) ◽  
pp. 357-361 ◽  
Author(s):  
Frances K. Conley ◽  
Richard D. Hamilton ◽  
Yoshio Hosobuchi
Keyword(s):  
Surgical Treatment ◽  
Cavernous Sinus ◽  
Content Type ◽  
Bilateral Carotid ◽  
Carotid Cavernous Fistulas ◽  
Fine Print

✓ The authors report a case of traumatic bilateral carotid-cavernous sinus fistulas, successfully treated by surgical electrothrombosis of both cavernous sinuses.

Onyx embolization of a carotid cavernous fistula via direct transorbital puncture

2011 ◽  
Vol 114 (1) ◽  
pp. 129-132 ◽  
Author(s):  
Mohamed Samy Elhammady ◽  
Eric C. Peterson ◽  
Mohammad Ali Aziz-Sultan
Keyword(s):  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Superior Ophthalmic Vein ◽  
Carotid Cavernous Fistula ◽  
Ethylene Vinyl Alcohol ◽  
Embolic Agents ◽  
Superior Petrosal Sinus ◽  
Carotid Cavernous Fistulas ◽  
Transvenous Approach ◽  
Pterygoid Plexus

The treatment of indirect carotid cavernous fistulas (CCFs) is challenging and primarily accomplished by endovascular means utilizing a variety of embolic agents. Transvenous access to the cavernous sinus is the preferred method of embolizaiton of indirect CCFs as they are frequently associated with numerous small-caliber meningeal branches. Although the inferior petrosal sinus is the simplest, shortest, and most commonly used venous route to the cavernous sinus, the superior ophthalmic vein, superior petrosal sinus, basilar plexus, and pterygoid plexus present other endovenous options. Occasionally, however, use of these venous routes may not be possible due to vessel tortuosity or sinus thrombosis and occlusion. The authors report a case of an indirect CCF that could not be treated endovascularly due to inability to access the cavernous sinus via a transfemoral transvenous approach. Angiography revealed a small, deeply located superior ophthalmic vein that was thought to be suboptimal for a direct cutdown. The cavernous sinus was cannulated directly via a transorbital approach using fluoroscopic guidance with a 3D skull reconstruction overlay. The fistula was subsequently obliterated using ethylene vinyl alcohol copolymer (Onyx). The technique and advantages of both 3D osseous reconstruction as well as Onyx embolization are discussed.

Treatment of carotid-cavernous fistulas by cavernous sinus occlusion

1979 ◽  
Vol 50 (2) ◽  
pp. 131-144 ◽  
Author(s):  
Sean Mullan
Keyword(s):  
Carotid Artery ◽  
Cavernous Sinus ◽  
Content Type ◽  
Carotid Cavernous Fistulas ◽  
Fine Print

✓ The author reports the occlusion of 33 carotid-cavernous fistulas in 31 patients using thrombogenic techniques. In one patient the carotid artery had been occluded previously, in one it was occluded deliberately, and with 31 fistulas it was preserved. There was no mortality and virtually no morbidity.

Carotid cavernous fistula: direct repair with preservation of the carotid artery

1973 ◽  
Vol 38 (1) ◽  
pp. 99-106 ◽  
Author(s):  
Dwight Parkinson
Keyword(s):  
Carotid Artery ◽  
Cavernous Sinus ◽  
Case Reports ◽  
Direct Approach ◽  
Illustrative Case ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Carotid Cavernous Fistulas ◽  
Fine Print

✓ The techniques and advantages of the direct approach to carotid cavernous fistulas with repair of the fistula and preservation of the carotid artery are discussed with illustrative case reports. The surgical significance of the anatomy of the parasellar venous structures and their relationship to the carotid artery are discussed. Two points emphasized are that it is possible to operate within the cavernous sinus and still be outside both the venous and arterial components of the fistula, and that, by one means or another, the carotid should be preserved.

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