Endovascular treatment of post-traumatic direct carotid-cavernous fistulas: A single-center experience

Spontaneous Direct Carotid-Cavernous Fistula in an Elderly Patient

“…9,10 Subsequently, ocular disorders such as orbital pain, diplopia (88%) and blurred vision may occur. 3,8,9 According to Ellis et al, these disorders are caused by ischemia of the retina and require urgent treatment.…”

“…9,10 Subsequently, ocular disorders such as orbital pain, diplopia (88%) and blurred vision may occur. 3,8,9 According to Ellis et al, these disorders are caused by ischemia of the retina and require urgent treatment. 1 Wang et al share that ophthalmoplegia is observed in 23-63% of cases, while disturbances in other cranial nerves are less common (17-44%), which is confirmed by the clinical presentation observed in our case.…”

“…1 Wang et al share that ophthalmoplegia is observed in 23-63% of cases, while disturbances in other cranial nerves are less common (17-44%), which is confirmed by the clinical presentation observed in our case. 9 CT and magnetic resonance angiography can visualize the dilated cavernous sinus and diagnose the CCF. The conventional cerebral DSA is the diagnostic method of choice, which not only do show the presence of an aneurysm in the intracavernous part of ICA, but also visualizes an existing fi stula and its drainage.…”

“…The aim of CCF treatment is to completely obstruct the fi stula and preserve adequate blood fl ow through the ICA. 9,10 Currently, the transarterial and transvenous embolization by coils and/or liquid embolic agents is the gold standard in the treatment of CCF. 8,9 Complications after the endovascular treatment of CCF are observed in 2-5% of cases and include brain infection, visual disturbances, diabetes insipidus, venous thrombosis, ophthalmoplegia, transient paralysis of cranial nerves and occlusion of the internal carotid artery due to protrusion of coils.…”

Temporary cranial nerve paralysis due to carotid cavernous fistula

“…Carotid cavernous fi stulas' classifi cation systems, complications and treatment modalities have been well described in the literature [5][6][7] . Retrograde cortical venous drainage is defi ned as an important risk factor, which is a sign for elevated intracranial venous pressure Over-packing of the cavernous sinus is one possible reason for transient cranial nerve symptoms; other possible causes are progressive thrombosis of the cavernous sinus and direct injury of the nerve by coil or microwire/microcatheter 14,15 .…”