Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
권호 표지
DOI QR코드

DOI QR Code

Parent artery occlusion of a giant internal carotid artery pseudoaneurysm-related direct carotid cavernous fistula: A case report

  • Alexander Andreev (Department of Neurology, Beth Israel Deaconess Medical Center) ;
  • Nadia McMillan (Department of Neurology, Beth Israel Deaconess Medical Center) ;
  • Kelli Money (Department of Neurology, Beth Israel Deaconess Medical Center) ;
  • Max Shutran (Division of Neurosurgery, Beth Israel Deaconess Medical Center) ;
  • Christopher Ogilvy (Division of Neurosurgery, Beth Israel Deaconess Medical Center)
  • Received : 2022.03.30
  • Accepted : 2022.10.06
  • Published : 2023.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Traumatic internal carotid artery injuries can produce direct carotid-cavernous fistulas as well as giant internal carotid artery pseudoaneurysms. Clinical sequelae can include headaches, cranial nerves palsies, proptosis, chemosis and optic neuropathy with visual loss as the most dangerous complication. Herein, we present a case of one of the largest reported internal carotid artery pseudoaneurysms associated with a direct carotid cavernous fistula. We describe the techniques and pitfalls of treatment with parent vessel occlusion.

Keywords

References

  1. Barrow DL, Spector RH, Braun IF, Landman JA, Tindall SC, Tindall GT. Classification and treatment of spontaneous carotid-cavernous sinus fistulas. J Neurosurg. 1985 Feb;62(2):248-56. 
  2. Choulakian A, Drazin D, Alexander MJ. Endosaccular treatment of 113 cavernous carotid artery aneurysms. J Neurointerv Surg. 2010 Dec;2(4):359-62. 
  3. Eliava SS, Filatov YM, Yakovlev SB, Shekhtman OD, Kheireddin AS, Sazonov IA, et al. Results of microsurgical treatment of large and giant ICA aneurysms using the retrograde suction decompression (RSD) technique: series of 92 patients. World Neurosurg. 2010 Jun;73(6):683-7. 
  4. Ghorbani M, Griessenauer CJ, Wipplinger C, Abdolhoseinpour H, Bahrami R, Asaadi S, et al. Combined endovascular and endoscopic approach for treatment of concomitant sphenoid sinus giant traumatic aneurysm and direct carotid cavernous fistulas. World Neurosurg. 2020 Feb;134:211-4. 
  5. Hauck EF, Welch BG, White JA, Replogle RE, Purdy PD, Pride LG, et al. Stent/coil treatment of very large and giant unruptured ophthalmic and cavernous aneurysms. Surg Neurol. 2009 Jan;71(1):19-24; discussion 24. 
  6. Henderson AD, Miller NR. Carotid-cavernous fistula: current concepts in aetiology, investigation, and management. Eye (Lond. Engl.) 2018 Feb;32(2):164-72. 
  7. Hoffmann M. Isolated right temporal lobe stroke patients present with Geschwind Gastaut syndrome, frontal network syndrome and delusional misidentification syndromes. Behav Neurol. 2008;20(3):83-9. 
  8. Narayan DN, Jayprakash SV, Arjun D, Achal G. Coil embolisation of post traumatic giant supraclinoid pseudoaneurysm presenting as carotid cavernous fistula. Asian J Neurosurg. 2018 Oct-Dec;13(4):1244-6. 
  9. Ringer AJ, Salud L, Tomsick TA. Carotid cavernous fistulas: anatomy, classification, and treatment. Neurosurg Clin N Am. 2005 Apr;16(2):279-95, viii. 
  10. Thomas AJ, Chua M, Fusco M, Ogilvy CS, Tubbs RS, Harrigan MR, et al. Proposal of venous drainage-based classification system for carotid cavernous fistulae with validity assessment in a multicenter cohort. Neurosurgery. 2015 Sep;77(3):380-5;discussion 385.