Carotid-cavernous-sinus fistula

Meder JF, Devaux B, Merland JJ et al (1995) Spontaneous disappearance of a spinal dural arteriovenous fistula. AJNR Am J Neuroradiol 16 2058-2062 Miki T, Nagai K, Saitoh Y et al (1988) Matas procedure in the treatment of spontaneous carotid cavernous sinus fistula a complication of retinal hemorrhage. No Shinkei Geka 16 971-976... 

Miller NR, Monsein LH, Debrun GM et al (1995) Treatment of carotid-cavernous sinus fistulas using a superior ophthalmic vein approach. J Neurosurg 83 838-842 Mironov A (1998) Selective transvenous embolization of dural fistulas without occlusion of the dural sinus. AJNR Am J Neuroradiol 19 389-391... 

In the transvenous approach for treatment of direct carotid-cavernous sinus fistulae, unintentional coil prolapse in the supplying artery is a feared compfication, which may result in emboHc stroke. Due to dramatically reduced reconstruction times down to less than 1 min, FD-CT can be quickly performed and thus might be very helpful in the assessment of coil protrusions in the parent artery, otherwise not visible in 2D projections (Fig. 40.11). 

Thrombosis of the cavernous sinus is characterized by proptosis, chemosis, impaired vision and ophthalmoplegia. If it is not septic, prognosis is good because of collateral drainage and spontaneous recanalization. The same symptoms, with the exception of a possible bruit, may result from arteriovenous shunting in carotid-cavernous fistulae. The treatment of choice in this case is endovascular occlusion (thrombosis ) of the cavernous sinus. 

Kawaguchi T, Kawano T, Kaneko Y et al (1999a) Dural arteriovenous fistula of the transverse sigmoid sinus after transvenous embolization of the carotid cavernous fistula. No To Shinkei 51 1065-1069... 

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