Traumatic carotid-cavernous fistula (TCCF) is a direct communication between cavernous portion of the internal carotid artery (ICA) and cavernous sinus due to tear in ICA. Most of the cases are treated by endovascular embolization. Spontaneous resolution of high-flow TCCFs is extremely rare. We report a case of posttraumatic, direct, high-flow carotid cavernous fistula (Barrow type A) that resolved spontaneously after cerebral angiography.
Vein of Galen aneurysmal malformations (VGAMs) are rare vascular malformations occurring commonly in the pediatric age group. They comprise only 1% of all intracranial vascular malformations, but in pediatric population, they represent 30% of all intracranial vascular malformations. They are of two types-mural and choroidal. Choroidal type of VGAM is more primitive and most severe form of disease. It usually causes high cardiac output failure in newborn period because of multiple high flow fistulas. Adult presentation of choroidal type VGAM is very rare, and only few cases have been reported in literature so far. A 21-year-old female patient presented with an orthostatic headache. Neuroimaging showed the choroidal type of VGAM. Staged embolization was planned through transarterial route. Partial embolization was done in the first stage. Patient's symptoms were disappeared thereafter. As per our knowledge, orthostatic headache has not been described previously in literature. With a very few existing case reports of adult true vein of Galen malformations, we believe that this case can help in understanding the natural history of vein of Galen malformations and the pathophysiology of its development.
Moyamoya disease is a progressive steno-occlusive disease of bilateral internal carotid artery with the development of fine collateral vessels and is an angiographic diagnosis. Concurrent Moyamoya disease with intracranial aneurysm had been reported in literature by various authors. Moyamoya disease is reported with aneurysm at various locations including basilar tip, anterior choroidal artery, posterior choroidal artery, anterior cerebral artery and middle cerebral artery. After reviewing literature thoroughly there is not a single case report on Moyamoya disease with isolated distal anterior cerebral artery aneurysm with the best of our knowledge. Here we are reporting a case of Moyamoya disease of left petrous and cavernous part of internal carotid artery with contralateral distal anterior cerebral artery aneurysm in a 36-year-old male.
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