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Coils and Onyx Embolization of Traumatic Carotid-Cavernous Fistula Caused by an Intradural Internal Carotid Artery Pseudoaneurysm

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机构: [1]251 Hosp Peoples Liberat Army, Neurosurg Dept, Zhangjia Kou, Hebei, Peoples R China; [2]Capital Med Univ, Tiantan Hosp, Beijing Neurosurg Inst, 6 Tiantan Xili, Beijing 100050, Peoples R China
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关键词: carotid-cavernous fistula endovascular therapy pseudoaneurysm

摘要:
A rare case of traumatic carotid-cavernous fistula caused by an intradural internal carotid artery pseudoaneurysm arising from the intradural internal carotid artery is described. The presentation was similar to that of carotid-cavernous fistulae, with ocular pain, chemosis and proptosis being the common symptoms. The patient was successfully treated by transarterial coil and Onyx-34 embolization. A 40-year-old man presented with severe injury, including multiple fractures of ribs, clavicle scapula and blind left eye. He gradually recovered and was discharged after intensive treatment in a local hospital. But about 70 days after discharge, his left eye became gradually chemotic and he felt a pulsatile bruit in his left ear. A CT scan and DSA confirmed a large intradural pseudoaneurysm and the associated carotid-cavernous fistula. Angiography revealed a fistula between the intradural aneurysm and the cavernous sinus. The origin of the aneurysm was above the posterior communicating artery. The aneurysm was successfully obliterated with detachable coils and Onyx-34 with the protection of a Hyperglide balloon. Subsequent studies demonstrated no flow through the fistula and good opacification of the ipsilateral internal cerebral artery system. Intradural pseudoaneurysm associated with carotid-cavernousfistula is a rare sequel of trauma. It may be treated successfully with the use of transarterial coil and Onyx embolization.

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大类 | 4 区 医学
小类 | 4 区 神经成像
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第一作者机构: [1]251 Hosp Peoples Liberat Army, Neurosurg Dept, Zhangjia Kou, Hebei, Peoples R China;
通讯作者:
通讯机构: [2]Capital Med Univ, Tiantan Hosp, Beijing Neurosurg Inst, 6 Tiantan Xili, Beijing 100050, Peoples R China
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