scholarly journals Cavernous Sinus Dural Arteriovenous Fistula in a Patient with Thyroid-Associated Ophthalmopathy: Complete Resolution after Medical Treatment

2021 ◽  
Vol 12 (1) ◽  
pp. 45
Author(s):  
Nicola Cavasin ◽  
Fabio Presotto ◽  
Matteo Bellamio ◽  
Enrico Cagliari
Keyword(s):  
Cavernous Sinus ◽  
Medical Therapy ◽  
Complete Resolution ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Endovascular Embolization ◽  
External Carotid ◽  
First Line ◽  
Ocular Symptoms ◽  
Thyroid Associated Ophthalmopathy

Thyroid-associated ophthalmopathy (TAO) is a well-known and frequent epiphenomenon of a hyperthyroid autoimmune disease that can present with proptosis, strabismus, and diplopia. Ophthalmopathy can occur in the absence of overt Graves’ disease, even in euthyroid patients. Cavernous sinus dural fistulas (CS-DAVF) are abnormal communications between the cavernous sinus (CS) and dural branches from internal carotid or external carotid arteries. They can often present with ocular symptoms that can mimic a thyroid-associated ophthalmopathy. CS-DAVF are usually successfully treated with an endovascular embolization that can be pursued both through a transvenous or transarterial approach. TAO and CS-DAVF can coexist especially when the ocular symptoms are unilateral. In those cases, an endovascular embolization is usually curative, but sometimes the procedure can fail. Our hypothesis is that some cases of CS-DAVF may be of secondary nature (i.e., caused by compression of the venous outlet by the hypertrophic ocular muscles); therefore, treating the ocular disease with medical therapy may solve the vascular problem as well. We present a case of a CS-DAVF in a patient with TAO successfully treated with sole medical therapy after the failure of a first-line endovascular treatment.

External carotid-cavernous sinus fistula diagnosed by common carotid arteriography

1974 ◽  
Vol 41 (4) ◽  
pp. 494-498 ◽  
Author(s):  
Louis Wener ◽  
Giovanni Di Chiro ◽  
Robert A. Mendelsohn
Keyword(s):  
Cavernous Sinus ◽  
Carotid Arteries ◽  
External Carotid ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Carotid Cavernous Sinus Fistula ◽  
The Difference ◽  
Fine Print

✓ An external carotid-cavernous fistula diagnosed by serial common carotid arteriography is reported. The diagnosis was reached on the basis of the difference in time between filling of the distal internal and external carotid arteries and the visualization of the fistula.

Orbital Vascular And Lymphatic Systems

2012 ◽  
Author(s):  
David Jordan ◽  
Louise Mawn ◽  
Richard L. Anderson
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
External Carotid ◽  
Sympathetic Nerve Fibers ◽  
Carotid Canal ◽  
Cervical Ganglion

The anatomy of the orbital vascular bed is complex, with tremendous individual variation. The main arterial supply to the orbit is from the ophthalmic artery, a branch of the internal carotid artery. The external carotid artery normally contributes only to a small extent. However, there are a number of orbital branches of the ophthalmic artery that anastomose with adjacent branches from the external carotid artery, creating important anastomotic communications between the internal and external carotid arterial systems. The venous drainage of the orbit occurs mainly via two ophthalmic veins (superior and inferior) that extend to the cavernous sinus, but there are also connections with the pterygoid plexus of veins, as well as some more anteriorly through the angular vein and the infraorbital vein to the facial vein. A working knowledge of the orbital vasculature and lymphatic systems is important during orbital, extraocular, or ocular surgery. Knowing the anatomy of the blood supply helps one avoid injury to the arteries and veins during operative procedures within the orbit or the eyelid. Inadvertent injury to the vasculature not only distorts the anatomy and disrupts a landmark but also prolongs the surgery and might compromise blood flow to an important orbital or ocular structure. Upon entering the cranium, the internal carotid artery passes through the petrous portion of the temporal bone in the carotid canal and enters the cavernous sinus and middle cranial fossa through the superior part of the forame lacerum . It proceeds forward in the cavernous sinus with the abducens nerve along its side. There it is surrounded by sympathetic nerve fibers (the carotid plexus ) derived from the superior cervical ganglion. It then makes an upward S-shaped turn to form the carotid siphon , passing just medial to the oculomotor, trochlear, and ophthalmic nerves (V1). After turning superiorly in the anterior cavernous sinus, the carotid artery perforates the dura at the medial aspect of the anterior clinoid process and turns posteriorly, inferior to the optic nerve.

scholarly journals Type D Traumatic Carotido-Cavernous Fistula Due to Selective Transection of the Inferolateral Trunk(ILT)

2003 ◽  
Vol 9 (4) ◽  
pp. 373-377 ◽  
Author(s):  
I.C. Duncan ◽  
P.A. Fourie
Keyword(s):  
Carotid Arteries ◽  
Internal Carotid ◽  
Traumatic Injury ◽  
External Carotid Artery ◽  
External Carotid ◽  
Type D ◽  
Type C ◽  
Transvenous Approach ◽  
Internal Carotid Arteries ◽  
Inferolateral Trunk

A minority of traumatic carotido-cavernous fistulas (CCF) are of the indirect variety, and then usually supplied only by meningeal branches of the ipsilateral external carotid artery (Type C). We describe a case of a Type D CCF due to traumatic injury of the inferolateral trunk (ILT), and describe its angiographic features and endovascular management through both the external and internal carotid arteries following a failed transvenous approach.

Type D Dural Carotid—Cavernous Fistula

1996 ◽  
Vol 37 (1P1) ◽  
pp. 294-298 ◽  
Author(s):  
K. Hasuo ◽  
A. Mizushima ◽  
S. Matsumoto ◽  
A. Uchino ◽  
S. Uehara ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Complete Resolution ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Symptomatic Improvement ◽  
Carotid Cavernous Fistula ◽  
Type D ◽  
One Year ◽  
Carotid Cavernous Fistulas ◽  
Internal Carotid Arteries

Purpose: To assess the efficacy of irradiation combined with particulate embolization for treating type D dural carotid—cavernous fistulas, supplied by the meningeal branches of both external (ECA) and internal carotid arteries. Material and Methods: Nine patients were treated by particulate embolization via the ECA branches, followed by radiation therapy with doses of 30 Gy. One of these patients with recurrent symptoms received an additional 30 Gy one year after initial treatment, making a total dose of 60 Gy. Results: In all cases, symptoms were improved immediately after the particulate embolizations. In 8 cases, complete resolution of symptoms were obtained in 4–19 months and an average of 8 months after treatment. In one case, chemosis was markedly improved and persisted minimally 41 months later. Conclusion: Particulate embolization is effective for immediate symptomatic improvement, and complete resolution of symptoms can usually be achieved by subsequent radiation therapy.

scholarly journals Variations, relations and clinical significance of carotid arterial system in anterior neck: a cadaveric study

2019 ◽  
Vol 7 (4) ◽  
pp. 1127
Author(s):  
Anasuya Ghosh ◽  
Subhramoy Chaudhury ◽  
Atin Datta
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Hypoglossal Nerve ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
Arterial System ◽  
External Carotid ◽  
The Common ◽  
Carotid Arterial

Background: The common carotid, internal and external carotid arteries and their branches serve as major source of blood supply in head-neck region of human and are often encountered during numerous surgical and clinical interventions of neck.Methods: We dissected and examined both sides of neck in 49 well embalmed cadavers (98 sides). We recorded the following anatomical parameters of carotid arterial system-level of bifurcation, the relation between internal and external carotid arteries, branching pattern of anterior branches of external carotid artery, tortuosity in carotid arterial system, and relation of hypoglossal nerve with the carotid arteries.Results: In 56.16 % cases, the common carotid arterial bifurcation took place at the upper border of thyroid cartilage though high bifurcation was quite common (43.88%). The external carotid artery was located antero-medial to internal carotid artery in most cases (93.87%). Abnormal tortuosity of carotid arterial system was detected in 2.04% cases only. In 86.73% cases, the hypoglossal nerve crossed the internal and external carotid artery superior to carotid bifurcation above the level of hyoid bone while in 1 case it crossed immediately inferior to carotid bifurcation. In branching pattern, following variations were observed- linguo-facial trunk in 15.3% cases, thyro-lingual trunk in 5.1% cases, origin of superior thyroid artery from common carotid in 10.02% cases and origin of superior thyroid from internal carotid in one case (1.02%).Conclusions: The carotid arterial system has complex and variable anatomy in neck and this information should be kept in mind to avoid unwanted damage during surgical procedures of neck.

scholarly journals Unusual position of external carotid artery: a case report

2005 ◽  
Vol 38 (02) ◽  
pp. 170-171
Author(s):  
S B Rao ◽  
V R Vollala ◽  
M Rao ◽  
V P Samuel ◽  
D Deepthinath ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Clinical Importance ◽  
Lateral Position ◽  
External Carotid Artery ◽  
External Carotid ◽  
Unusual Position ◽  
The Common ◽  
Internal Carotid Arteries

AbstractThe arterial pattern of the human body is one of the systems that show a large number of variations. Many reports are available regarding variations of common carotid, external and internal carotid arteries and branches of external carotid artery. We describe a very rare case of lateral position of external carotid artery. The external carotid artery was lateral to the internal carotid artery at the bifurcation of the common carotid artery. The clinical importance of this variation is discussed.

Doppler Angiography for the Non-Invasive Investigation of the Carotid Artery in the Neck

1979 ◽  
Author(s):  
Charles Warlow ◽  
Peter Fish
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Doppler Imaging ◽  
Ultra Sound ◽  
External Carotid ◽  
Flow Profile ◽  
Non Invasive ◽  
Velocity Flow ◽  
Internal Carotid Arteries

The accuracy, and possible clinical application of non-invasive ultra sound imaging of the cervical carotid, artery in patients with cerebrovascular disease has been investigated by comparing a pulsed multi-channel directional Doppler imaging devise (“MAVIS” - GEC Medical) with conventional carotid angiography. Of 23 normal or minimally diseased internal carotid arteries only 4 appeared as stenosed on Doppler angiography, the other 19 were normal; of 14 stenosed arteries only 1 appeared normal on imaging,1 appeared occluded end 12 showed clear images of stenosis; all 6 occluded arteries appeared occluded on ultra sound imaging. It was difficult to obtain satisfactory images of the external carotid arteries in all cases. The additional facility to display a velocity flow profile at preselected points along the arterialimage should increase the usefulness of this technique, particularly when there is only minor atheromatous irregularity or ulceration, and such a device will be briefly disrussed.

scholarly journals Stenting in the Remnant of the Third Aortic Arch in a Case of Post-Irradiation Occluded Internal Carotid Artery

2011 ◽  
Vol 17 (1) ◽  
pp. 22-26
Author(s):  
H.-C. Chen ◽  
C.-J. Lin ◽  
F.-C. Chang ◽  
C.-B. Luo ◽  
Y.-J. Lai ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Transluminal Angioplasty ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
External Carotid ◽  
First Case ◽  
Internal Carotid Arteries

Collateral networks between the external carotid artery and internal carotid arteries become crucial for cerebral perfusion after occlusion of internal carotid arteries. We report the first case of a patient who received percutaneous transluminal angioplasty and stenting in a collateral vessel between the external and internal carotid artery for treatment of radiation induced severe stenosis of the internal carotid artery in the context of a contralateral internal carotid artery occlusion.

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