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Case Reports
. 2011 Jan;6(1):45-8.
doi: 10.4103/1793-5482.85637.

Transvenous embolization in spontaneous direct carotid-cavernous fistula in childhood

Glenna B Mercado  1 , Keiko Irie, Makoto Negoro, Shigeta Moriya, Teppei Tanaka, Masahiro Ohmura, Akiyo Sadato, Motuharu Hayakawa, Hirotoshi Sano
Affiliations
Case Reports

Transvenous embolization in spontaneous direct carotid-cavernous fistula in childhood

Glenna B Mercado et al. Asian J Neurosurg. 2011 Jan.

Abstract

Carotid cavernous fistula (CCF) is an abnormal arteriovenous communication in the cavernous sinus. Direct CCF results from a tear in the intracavernous carotid artery. Typically, it has a high flow and usually presents with oculo-orbital venous congestive features such as exophthalmos, chemosis, and sometimes oculomotor or abducens cranial nerve palsy. Indirect CCF generally occurs spontaneously with subtle signs. We report a rare case of spontaneous direct CCF in childhood who did not have the usual history of craniofacial trauma or connective tissue disorder but presented with progressive chemosis and exophthalmos of the right eye. This report aims also to describe the safety and success of transvenous embolization with coils of the superior ophthalmic vein and cavernous sinus through the inferior petrosal sinus.

Keywords: Childhood; direct carotid cavernous fistula; transvenous embolization.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Pre-embolization angiography AP (a) and lateral (b) views showing the fistula at the level of C4 of the right ICA shunting to the right SOV, right IPS and cavernous sinus
Figure 2
Figure 2
Post-embolization angiography AP (a) and lateral (b) views showing complete disappearance of AV shunts and the preservation of the patency of the right ICA
Figure 3
Figure 3
Plain skull X-ray AP (a) and lateral (b) views showing dense coiling of the right SOV and cavernous sinus
See this image and copyright information in PMC

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