Dural carotid cavernous fistula: definitive endovascular management and long-term follow-up

Meyers, Philip M.; Halbach, Van V.; Dowd, Christopher F.; Lempert, Todd E.; Malek, Adel M.; Phatouros, Constantine C.; Lefler, James E.; Higashida, Randall T.

doi:10.1016/s0002-9394(02)01515-5

Cited by 241 publications

(180 citation statements)

References 19 publications

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“…2,3 Theoretically, the symptoms may be aggravated during pregnancy due to the associated haemodynamic and hormonal changes, causing engorgement of the veins. Since our patient had no history of head injury and was previously asymptomatic, the CCF was more than likely de novo.…”

Section: Discussionmentioning

confidence: 99%

“…4 Cerebral haemorrhage could occur in 30 to 40% of patients due to drainage directly into cerebral veins. 3 Spontaneous intracranial haemorrhage from an occult CCF in pregnancy and puerperium has been reported, and it was stressed that cerebral angiography should be performed to confirm the true disappearance of a CCF. 5 Carotid cavernous fistula per se has no adverse effect on pregnancy, 6 but the potentially serious maternal complications like intracranial haemorrhage may cause fetal and maternal morbidity or even mortality.…”

Section: Discussionmentioning

confidence: 99%

“…3 However, spontaneous improvement of CCFs during or just after pregnancy appears to be rare. 9 Toya et al 10 reported such an occurrence in a patient with a dural CCF, which ensued 21 days after an abortion at 12 weeks of gestation.…”

Section: Discussionmentioning

confidence: 99%

“…Meticulous clinical and radiological evaluations are crucial in making an accurate diagnosis. 3 A correct diagnosis is important, as a CCF could be associated with serious maternal complications such as blindness and intracranial haemorrhage.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Spontaneous carotid cavernous fistula complicating pregnancy

Yeung

Suen²,

Yu³

et al. 2013

Hong Kong Med J

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Spontaneous carotid cavernous fistula complicating pregnancy

Yeung

Suen²,

Yu³

et al. 2013

Hong Kong Med J

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“…[3][4][5][6] Treatment modalities include transarterial or transvenous endovascular embolization to occlude the arteriovenous fistula site, microsurgical interruption of the fistula site, stereotactic radiosurgery, or multimodality therapy. Endovascular procedures are used to treat a most DAVFs and are the treatment of choice for lesions accessible to catheterization.…”

mentioning

confidence: 99%

Progressive versus Nonprogressive Intracranial Dural Arteriovenous Fistulas: Characteristics and Outcomes

Hetts

Tsai

Cooke

et al. 2015

AJNR Am J Neuroradiol

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Unilateral Proptosis, Redness, Diplopia, and Numbness in a Young Woman

2016

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A woman in her 30s with no significant medical history presented with a 1-month history of worsening "bulging," redness, and mild pain in her right eye. She also reported intermittent, binocular diplopia. Results from a review of systems were otherwise negative, and she had not experienced recent trauma. She was started on topical antihypertensive drugs for elevated intraocular pressure (IOP) in the affected eye (30 mm Hg) and referred to our institution. On examination, visual acuity was 20/20 in both eyes with subjective red desaturation OD. Pupils were equal and without afferent pupillary defect. Confrontation visual fields were full. Intraocular pressures were 24 mm Hg OD and 12 mm Hg OS. Hertel exophthalmometry showed 4.5 mm of relative proptosis OD. She had limitation of her extraocular muscles in nearly all fields of gaze OD, with the most obvious limitation occurring in abduction. She had decreased sensation to light touch in the right cheek (cranial nerve V2). There were no orbital bruits. Ocular examination revealed diffuse conjunctival injection OD with tortuous, dilated, corkscrew-shaped blood vessels (Figure , A). Dilated fundus examination revealed mild optic nerve hyperemia and mild vascular tortuosity OD. Vital signs and results from complete blood cell count and thyroid function tests were normal. Computed tomography and magnetic resonance imaging, angiography, and venography of the brain and orbits revealed extraocular muscle enlargement and enhancement and a dilated superior ophthalmic vein OD. There was no mass, abscess, or arteriovenous fistula (Figure , B). MRI of orbits B Conjunctival injection and proptosis A Figure. A, External photograph demonstrating diffuse conjunctival injection and proptosis of the right eye. B, Contrast-enhanced, fat-suppressed, T1-weighted magnetic resonance imaging of the orbits demonstrating a dilated superior ophthalmic vein and extraocular muscle enlargement of the right eye. WHAT WOULD YOU DO NEXT? A. Orbital biopsy B. Start systemic corticosteroids C. Start systemic antibiotics D. Order catheter cerebral angiography Clinical Review & Education

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Dural carotid cavernous fistula: definitive endovascular management and long-term follow-up

Cited by 241 publications

References 19 publications

Spontaneous carotid cavernous fistula complicating pregnancy

Spontaneous carotid cavernous fistula complicating pregnancy

Progressive versus Nonprogressive Intracranial Dural Arteriovenous Fistulas: Characteristics and Outcomes

Unilateral Proptosis, Redness, Diplopia, and Numbness in a Young Woman

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