Post-traumatic carotid-cavernous fistula in a pediatric patient: a case-based literature review

Morais, Bárbara Albuquerque; Yamaki, Vítor Nagai; Caldas, José Guilherme Mendes Pereira; Paiva, Wellingson Silva; Matushita, Hamilton; Teixeira, Manoel Jacobsen

doi:10.1007/s00381-017-3668-7

Cited by 6 publications

(7 citation statements)

References 10 publications

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“…Direct CCFs are usually due to traumatic injury, represent 70-75% of CCFs encountered, are typically high flow connections, and are usually found in young males; CCF is rare in children (only 4% of all reported CCF cases). 4 Trauma and iatrogenic injuries are the most common etiologies, 5 with the presentation of these cases typically being abrupt. 6 Direct CCFs have been seen due to iatrogenic injury following mechanical thrombectomy 7 and transsphenoidal surgery.…”

Section: Discussionmentioning

confidence: 99%

Carotid cavernous fistula presenting as orbital cellulitis

Peterson

Lee²,

Lacy³

2023

The Chronicles

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Carotid cavernous fistula is a serious vascular pathology that is commonly misdiagnosed due to clinical signs that overlap with several other pathologies and the need for sensitive imaging techniques, most notably digital subtraction angiography, to make the diagnosis. Here we present a case of carotid cavernous fistula mimicking orbital cellulitis, ultimately diagnosed with magnetic resonance venography.

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Section: Discussionmentioning

confidence: 99%

Carotid cavernous fistula presenting as orbital cellulitis

Peterson

Lee²,

Lacy³

2023

The Chronicles

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“…She presented with chemosis, proptosis caused by venous engorgement and palsy of the third cranial nerve, and orbital murmur caused by the arterial flow in the superior ophthalmic vein. 3 Her traumatic high flow fistula resulted from a direct carotid lesion over the cavernous sinus following a basilar skull fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous fistulas are infrequent and often occur in the setting of other pathologies, such as Ehlers-Danlos syndrome. 3,13 Traumatic fistulas, such as type A (direct) fistula, are most often due to head trauma associated with craniofacial trauma and skull base fracture. 6,7 Our patient, a 2-year-old girl, was younger than all previously reported cases (►Table 1).…”

Section: Discussionmentioning

confidence: 99%

Challenging Management of an Acute Traumatic Carotid-Cavernous Fistula in a 2-Year-Old Child with Literature Review

Solis,

Macha,

Toledo

et al. 2023

Indian Journal of Neurosurgery

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Traumatic carotid-cavernous fistula (TCCF) is a rare occurrence in the pediatric population. However, the neurological sequelae of TCCF are associated with higher morbidity and mortality in pediatric patients. We report the case of a 2-year-old child with TCCF treated at a public hospital in Peru. The etiology of the injury was due to a fall of approximately 5 meters. The diagnosis was made based on the clinical picture and neuroimaging findings. The initial proposed treatment was performed with the hope of preserving the parent artery; however, due to persistence of the TCCF, embolization of the parent artery with coils and embolizing substance was performed. A literature review of similar cases was performed and identified eight cases in children under 10 years of age. Endovascular management of an acute TCCF is a challenge due to the high morbidity and mortality during the acute phase and can be complicated when other traumatic injuries are present. Maintaining the parent artery is important; however, when this is not possible, trapping the parent artery may provide an alternate option when appropriate collaterals exist.

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“…We reviewed the literature on posttraumatic CCF in pediatric patients aged 10 years or younger (Table 1) and found that Barburoglu et al reported two pediatric cases of CCF treated with flow diverter stents but gave no details about their age [1]. Only seven traumatic CCF cases in patients aged 10 years or younger who were treated with other methods have been reported [12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Flow diverter stents for pediatric traumatic carotid cavernous fistula: a case report and literature review

et al. 2021

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A 10-year-old, male patient with a head injury caused by a fall presented with chemosis, exophthalmos, right orbital bruit, and intracranial venous reflux, based on which posttraumatic carotid cavernous fistula (CCF) was diagnosed. Coil embolization was semi-urgently performed for the dangerous venous drainage. After the treatment, right abducens nerve palsy newly appeared. To treat the neurological symptoms and preserve the parent artery, curative endovascular treatment using a pipeline embolization device (PED) with coil embolization was performed after starting dual antiplatelet therapy (DAPT). The CCF and abducens nerve palsy finally resolved, and the internal carotid artery (ICA) was remodeled. Use of the PED with adjunctive coil embolization was effective and safe in the present case of pediatric traumatic direct CCF.

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Post-traumatic carotid-cavernous fistula in a pediatric patient: a case-based literature review

Abstract: CCF should be suspected in craniofacial traumas with ocular symptoms. The presence of a skull base fracture on CT is a poor predictor of CCF associated with head trauma. Early diagnosis and treatment can prevent permanent neurological deficits and unfavorable outcomes.

Cited by 6 publications

References 10 publications

Carotid cavernous fistula presenting as orbital cellulitis

Carotid cavernous fistula presenting as orbital cellulitis

Challenging Management of an Acute Traumatic Carotid-Cavernous Fistula in a 2-Year-Old Child with Literature Review

Flow diverter stents for pediatric traumatic carotid cavernous fistula: a case report and literature review

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