Long-term observations in cases with spontaneous carotid-cavernous fistulas

Sasaki, Hideo; Nukui, Hideaki; Kaneko, Masami; Mitsuka, Shigeru; Hosaka, Takeshi; Kakizawa, Toshiyuki; Kimura, Ryuji; Nagaseki, Yoshishige; Naganuma, Hirofumi

doi:10.1007/bf01560564

Cited by 67 publications

(21 citation statements)

References 9 publications

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“…Since spontaneous occlusion of a bilateral TCCF and spontaneous thrombosis of CCF following failed transarterial balloon occlusion have been reported (17,18), we speculate that stasis of venous flow and loss of venous pressure in TCCF may lead to stasis of blood flow in the superior petrosal sinus. Similar conditions have been reported in carotid-cavernous dural arteriovenous fistula (19,20) and in the ophthalmic vein following TCCF (21); therefore, thrombus formation due to stasis of the venous flow likely contributes to occlusion of the superior petrosal sinus in TCCF. Other factors may also contribute to occlusion of the superior petrosal sinus, however, including induction of thrombus formation by contrast agents either by directly acting on endothelial cells or via the accumulation of white and red blood cells.…”

Section: Discussionsupporting

confidence: 78%

Brainstem edema caused by traumatic carotid-cavernous fistula: A case report and review of the literature

Guo

Zhao

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. Brainstem edema caused by traumatic carotid-cavernous fistula (TCCF) is rare, and there is little information available regarding its clinical characteristics. The present report describes the case of a 51-year-old man with TCCF, who presented with right exophthalmos and intracranial bruit for 1 week. One month prior to admission at hospital, he fractured the frontal and ethmoid sinuses. Digital subtraction angiography confirmed the diagnosis of TCCF, and magnetic resonance imaging (MRI) suggested edema on the right side of the pons. Five days after admission, the patient exhibited left hemiparesis, and MRI revealed aggravation of the brainstem edema. Following treatment with transarterial balloon embolization, the clinical symptoms, including hemiparesis, were relieved; at the 1-month follow-up, the brain edema had disappeared. The patient was normal at the 6-month follow-up. Following the report of the present case, we reviewed six additional cases previously reported in the literature and discussed the potential mechanisms of TCCF-associated brainstem edema. We conclude that occlusion of the superior petrosal sinus may contribute to brainstem edema caused by TCCF. Relief of the brainstem edema and brainstem edema-associated clinical symptoms can be achieved with transarterial coil or balloon embolization of the TCCF to reduce the drainage pressure in the brainstem veins.

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Section: Discussionsupporting

confidence: 78%

Brainstem edema caused by traumatic carotid-cavernous fistula: A case report and review of the literature

Guo

Zhao

et al. 2015

Experimental and Therapeutic Medicine

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“…Given the benign features of low-flow CS DAVFs and possibility of spontaneous occlusion, some authors have advocated conservative treatments, including cervical carotid artery and jugular vein compressions, as first-line therapies for these lesions. 15,40 However, some cases present with intractable intraocular hypertension or reduced ocular perfusion pressure, thereby warranting more rapid interventions to prevent progressive vision loss. 36,40,49 Due to their unique anatomy and symptomatology, CS DAVFs are often categorized using the Barrow classification system.…”

Section: Comparison Of Cs Davfs and Ncs Davfsmentioning

confidence: 99%

“…15,40 However, some cases present with intractable intraocular hypertension or reduced ocular perfusion pressure, thereby warranting more rapid interventions to prevent progressive vision loss. 36,40,49 Due to their unique anatomy and symptomatology, CS DAVFs are often categorized using the Barrow classification system. 4 Type A fistulas represent direct high-flow shunts between the internal carotid artery and the CS, comprising mostly traumatic fistulas formed as a result of a tear in the cavernous segment of the internal carotid artery.…”

Section: Comparison Of Cs Davfs and Ncs Davfsmentioning

confidence: 99%

Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review

Chen¹,

Lee

Ding³

et al. 2015

JNS

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C urrent treatment strategies for intracranial dural arteriovenous fistulas (DAVFs) include microsurgical ligation, transarterial or transvenous embolization, stereotactic radiosurgery (SRS), and various combinations of these therapeutic options. Endovascular therapy, most commonly performed via transvenous routes, has become the preferred treatment approach for DAVFs. 27,44,48 Due to the immediate obliteration that can be achieved with endovascular or surgical occlusion, SRS is typically reserved for lesions that cannot be obliterated with endovascular or surgical approaches, or for patients who pose a high surgical risk due to medical comorbidities. Therefore, published SRS series for DAVFs remain relatively few and comprise mostly retrospective, single-center studies.In this systematic review, we evaluate the obliteration rate of DAVFs in patients treated with SRS. We also compare obliteration rates between cavernous sinus (CS) and noncavernous sinus (NCS) DAVFs, and between DAVFs with and without cortical venous drainage (CVD), by using available data in the literature. Methods inclusion CriteriaIn our attempt to balance between the largest possible patient population and a relatively homogeneous cohort, the following inclusion criteria for this systematic review were devised: 1) the study must contain at least 5 patients abbreviatioNs AVM = arteriovenous malformation; CS = cavernous sinus; CVD = cortical venous drainage; DAVF = dural arteriovenous fistula; GKS = Gamma Knife surgery; LINAC = linear accelerator; NCS = noncavernous sinus; SRS = stereotactic radiosurgery; TSS = transverse and sigmoid sinus. obJeCt The goal of this study was to evaluate the obliteration rate of intracranial dural arteriovenous fistulas (DAVFs) in patients treated with stereotactic radiosurgery (SRS), and to compare obliteration rates between cavernous sinus (CS) and noncavernous sinus (NCS) DAVFs, and between DAVFs with and without cortical venous drainage (CVD). Methods A systematic literature review was performed using PubMed. The CS DAVFs and the NCS DAVFs were categorized using the Barrow and Borden classification systems, respectively. The DAVFs were also categorized by location and by the presence of CVD. Statistical analyses of pooled data were conducted to assess complete obliteration rates in CS and NCS DAVFs, and in DAVFs with and without CVD. results Nineteen studies were included, comprising 729 patients harboring 743 DAVFs treated with SRS. The mean obliteration rate was 63% (95% CI 52.4%-73.6%). Complete obliteration for CS and NCS DAVFs was achieved in 73% and 58% of patients, respectively. No significant difference in obliteration rates between CS and NCS DAVFs was found (OR 1.72, 95% CI 0.66-4.46; p = 0.27). Complete obliteration in DAVFs with and without CVD was observed in 56% and 75% of patients, respectively. A significantly higher obliteration rate was observed in DAVFs without CVD compared with DAVFs with CVD (OR 2.37, 95% CI 1.07-5.28; p = 0.03). CoNClusioNs Treatment with SRS offers favorable rates of D...

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“…The spontaneous regression of dural AVFs has been reported (12)(13)(14). Such an observation, which might be caused by thrombosis of the sinus or fistula, is frequently associated with cavernous sinus dural AVFs; therefore, some dural AVFs can be treated conservatively.…”

Section: Conservative Treatmentmentioning

confidence: 99%

Treatment of Intracranial Dural Arteriovenous Fistulas: Current Strategies Based on Location and Hemodynamics, and Alternative Techniques of Transcatheter Embolization

Kiyosue¹,

Hori²,

Okahara³

et al. 2004

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Long-term observations in cases with spontaneous carotid-cavernous fistulas

Cited by 67 publications

References 9 publications

Brainstem edema caused by traumatic carotid-cavernous fistula: A case report and review of the literature

Brainstem edema caused by traumatic carotid-cavernous fistula: A case report and review of the literature

Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review

Treatment of Intracranial Dural Arteriovenous Fistulas: Current Strategies Based on Location and Hemodynamics, and Alternative Techniques of Transcatheter Embolization

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