ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. La fístula carótido-cavernosa, también conocida por sus iniciales FCC, es una comunicación anómala que se produce entre la arteria carótida y el seno cavernoso que se puede extender de forma anterógrada a la órbita y causar un daño importante en la estructura ocular. 2 article feature images from this case 9 public playlist include this case (advertising) Las fístulas carótido-cavernosas son comunicaciones anómalas entre el seno cavernoso y el sistema arterial carotídeo, poco frecuentes en la práctica m… All patients underwent pre- and postcontrast-enhanced CTA and digital subtraction angiography (DSA), and 50 patients also underwent MRA. AJNR Am J Neuroradiol 2005; 26: 2349–2356. 211, No. Nylon-fibred platinum coils are preferred to bare platinum coils due to their improved thrombogenicity.61 Use of 3D rotational angiography, an emerging imaging technique, permits identification of the fistula point and downstream venous sac. Minor transient complications, including haematoma, facial pain, and ocular motor nerve palsies, occur in 1–30% of cases.18 Major sequelae, including hemiparesis and permanent ocular motor nerve palsy, are quite rare in the general population; however, patients with Ehlers–Danlos type IV have much higher complication rates with both diagnostic and therapeutic endovascular procedures due to the underlying vascular fragility in this condition.4 In addition, some authors report often-overlooked, moderate, persistent ocular motor deficits, which they relate to coil volume, either indirectly, as a surrogate marker for the size of the initial vascular injury, or directly, via associated mass effect on the cranial nerves within the cavernous sinus.50, Treatment options for dural CCFs include observation, IOP-lowering agents, intermittent compression of the ipsilateral ICA or SOV, stereotactic radiosurgery, and endovascular intervention. La incidencia de fístula carótido-cavernosa (FCC) como resultado del trauma craneofacial es del 0,2 al 0,3%. The endovascular management of these lesions is currently possible with excellent results. En RM se objetiva un engrosamiento del SC  que contiene un tejido de partes blandas isointenso con el músculo en T1 e hipo o hiper en T2, Google Scholar. Revisión a propósito de un caso, Trombosis bilateral del seno cavernoso en un paciente con enfermedad periodontal y diabetes mellitus. J Craniomaxillofac Trauma. Feuerman TF, Hieshima GB, Bentson JR, Batzdorf U . Sopro pulsátil em globo ocular, hiperemia conjuntival e proptose (tríade clínica da fístula carotídeo-cavernosa, ocorrendo, respectivamente em 85%, 79% e 70% dos casos). A fístula carótido-cavernosa é uma comunicação patológica entre a artéria carótida interna e o seio cavernoso. Ohlsson M, Consoli A, Rodesch G . J Neuroradiol 2017; 44 (5): 326–332. CONCLUSION: Right caroticocavernous fistula supplied by the right meningohypophyseal trunk (Barrow type B); successfully embolized transvenously with Onyx-18. [2] They are considered direct when there is a direct connection between the internal. Smoker WRK, Gentry LR, Yee NK, Reede DL, Nerad JA. The definitive diagnosis is established by cerebral arteriography. Neurosurg Focus 2012; 32 (5): E9. Cesk Slov Oftalmol. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Please enable it to take advantage of the complete set of features! Miller NR. Neuroradiology 2004; 46 (12): 1012–1015. Fig. Neurosurg Clin N Am. doi: 10.1097/MD.0000000000032265. Progressive right eye visual acuity loss, diplopia with ophthalmoparesis, red eye and exophalthmos. These fistulas may be divided into spontaneous or traumatic in relation to cause and direct or dural in relation to angiographic findings. Endovascular transvenous occlusion of the cavernous sinus was successful, with resolution of symptoms. PMC Se reporta un enfermo con fistula carotideo-cavernosa de bajo flujo, asociada a hipertension arterial mal controlada, una situacion clinica infrecuente y que debe ser tenida en cuenta en the evaluacion of un paciente con proptosis no asociado a traumatismo externo o quirurgico. These pathologic conditions can have overlapping clinical manifestations. Ernst RJ, Tomsick TA (1997). de Keizer RJW . have also proposed further dividing type D into D1 (unilateral supply) and D2 (bilateral supply) 4. The ophthalmology of intracranial vascular abnormalities. DSA is able to dynamically evaluate the blood-flow through CS determining CCF drainage pattern and detect small feeding arteries or the exact site of the communication [2]. 2015;77(3):380–5. Radiographics. Approximately 70% of all CCFs are caused . Las fístulas . FOIA Neuroradiology 2001; 43 (11): 1007–1014. CAS  CTA and MRI findings suggested a caroticocavernous fistula. The site is secure. Traduzioni in contesto per "cavernoso muito" in portoghese-italiano da Reverso Context: Assim, existe um terreno cavernoso muito interessante em Marte, pelo menos desse tipo. When the IPS approach is not possible due to anatomic venular variations or thrombosis, an SOV approach may be used.29 The SOV is approached via an anterior orbitotomy, and a venous catheter is then advanced through the SOV into the cavernous sinus. Neuroradiology 2016; 58 (12): 1181–1188. 7. De acordo com as informações, uma mulher de 27 anos sofreu um trauma no crânio e apresentava uma complicação médica denominada fístula carótido-cavernosa.. Eighty patients (28.4%) were lost to follow-up for various reasons and at different points. Similarly, although most clinics do not have access to a pneumotonograph, pneumotonometry can be a valuable diagnostic tool, as a difference in ocular pulse amplitudes (defined as the difference between systolic and diastolic IOP) of 1.6 mm Hg between the two eyes has been shown to be 100% sensitive and 93% specific for a CCF (Figure 7).34 Orbital ultrasound typically reveals a dilated superior ophthalmic vein (SOV) and evidence of orbital congestion with enlarged extraocular muscles and also can be used to exclude mimickers of CCF, including orbital tumours, dysthyroid orbitopathy, orbital inflammation, and scleritis.37 Colour Doppler evaluates flow velocity and direction, thus indicating arterial flow in the orbital veins in cases of CCF.33 The presence of flow reversal in the SOV is suggestive of a CCF. Chen et al38 performed a retrospective study of 53 patients with angiographically confirmed direct or dural CCFs. Chong GT, Mukundan S, Kirkpatrick JP, Zomorodi A, Sampson JH, Bhatti MT . Interventional neurovascular treatment of traumatic carotid and vertebral artery lesions: results in 234 cases. According to Thomas classification, CCFs with posterior/inferior drainage only, posterior/inferior and anterior drainage, anterior drainage only, and retrograde drainage into cortical veins with/without other drainage channels were designated as types 1, 2, 3, and 4, respectively. Park SH, Park KS, Kang DH, Hwang JH, Hwang SK . Phan K, Xu J, Leung V, Teng I, Sheik-Ali S, Maharaj M et al. Teaching NeuroImages: carotid-cavernous fistula caused by fibromuscular dysplasia. A type A fistula is a direct, high flow fistula between the cavernous internal carotid artery and the cavernous sinus. Wakhloo AK, Perlow A, Linfante I, Sandhu JS, Cameron J, Troffkin N et al. Indications for treatment and classification of 132 carotid-cavernous fistulas. Prior to treatment, the common carotid arteriogram shows a dural CCF draining both anteriorly and posteriorly (left). Part 2: indications and therapeutic strategy], Perspectiva endovascular en el manejo de los aneurismas intracraneales. Las fístulas carótido cavernosas son malformaciones vasculares infrecuentes que generan un shunt arterio- venoso patológico que compromete el funcionamiento ocular. 19. J Neurointerv Surg 2011; 3 (1): 5–13. 24, Se objetiva ocupación y aumento de tamaño del SC.La diseminación puede ser por via hematógena ( riñón,mama,pulmón...) o perineural ( carcinomas escamosos, Kashiwagi S, Tsuchida E, Goto K, Shiroyama Y, Yamashita T, Takahasi M et al. Onyx embolization of a carotid cavernous fistula via direct transorbital puncture. eCollection 2020 Nov-Dec. Iampreechakul P, Wangtanaphat K, Lertbutsayanukul P, Wattanasen Y, Siriwimonmas S. Asian J Neurosurg. Google Scholar. de Keizer R. Carotid-cavernous and orbital arteriovenous fistulas: ocular features, diagnostic and hemodynamic considerations in relation to visual impairment and morbidity. J Clin Neurosci 2015; 22 (11): 1844–1846. Ophthalmology 1988; 95 (1): 121–130. A technical description and initial results. Direct carotid cavernous fistula after trigeminal balloon microcompression gangliolysis: case report. por dos vias: - Extensión directa : por destrucción ósea  o a través del canal carotideo. Neurology 2014; 82 (15): e134–e135. Am J Ophthalmol 2002; 134 (1): 85–92. La técnica es segura indirecta. 23. Coskun O, Hamon M, Catroux G, Gosme L, Courthéoux P, Théron J. Carotid-cavernous fistulas: diagnosis with spiral CT angiography. Compression is repeated several times per hour, for 10 s with each repetition initially, with progressive titration of treatment session duration to several minutes. MRA and MRV confirmed the diagnosis of CCF with markedly enlarged left SOV (G). 2015 Dec;24(12):2824-38. doi: 10.1016/j.jstrokecerebrovasdis.2015.08.016. Int J Ophthalmol. descripción de un caso, Oclusión intencional de la arteria subclavia izquierda durante el tratamiento endovascular de la aorta torácica descendente. Neurosurgery 1996; 39 (4): 853–855. Transvenous n-butyl-cyanoacrylate infusion for complex dural carotid cavernous fistulas: technical considerations and clinical outcome. años con una fístula carótido-cavernosa (FCC) por medio de un microcatéter. Dural and carotid cavernous sinus fistulas. 18. 2020 Nov 24;5(6):e097. Radiogr a Rev Publ Radiol Soc North Am Inc. 1995 May;15(3):589–608. AJNR Am J Neuroradiol 2006; 27: 2078–2082. Diagnosis of cavernous sinus artenovenous fistula by measurement of ocular pulse amplitude. Patients with any associated visual impairment or ocular conditions, such as glaucoma, need to be identified and treated. Apresentamos o caso de um paciente de 32 anos de idade com fístula. Clinical symptoms and signs usually present acutely in cases of direct fistula and are more indolent in dural fistulas. The .gov means it’s official. carótida interna y el seno cavernoso (SC). The evolution of endovascular treatment of carotid cavernous fistulas: a single-center experience. - Rama oftálmica del trigémino ( V1 ) : Lateral .Penetra en la órbita a través  de la fisura orbitaria superior. Trishal Jeeva Patel, Kirill Zaslavsky, … Edward Margolin, Feng-Chi Chang, Chao-Bao Luo, … Wan-Yuo Guo, Nohra Chalouhi, Ahmad Sweid, … Pascal Jabbour, Woo Sang Jung, Jin Soo Lee, … Jin Wook Choi, Jian Zhang, Pui Man Rosalind Lai, … Rose Du, Chia-Hung Wu, Shu-Ting Chen, … Han-Hwa Hu, Cheng-Hsuan Tsai, Ying-Hsien Chen, … Hsien-Li Kao, Hyoung Nam Lee, Seung Boo Yang, … Sangjoon Lee, Eye El tratamiento endovascular tuvo éxito clínico en 256 (91,1%). Recurrent bilateral subconjunctival hemorrhage. World J Radiol. [11] Kirsch M, Henkes H, Liebig T, Weber W, Esser J, Golik S et al. Check for errors and try again. intracavernous internal carotid artery, and the... meningeal branches of the intracavernous internal carotid artery, and the... meningeal branches of the external carotid artery, and the... meningeal branches of the intracavernous internal carotid artery (type B), and the... meningeal branches of the external carotid artery (type C), and the... 1. Adam CR, Shields CL, Gutman J, Kim HJ, Hayek B, Shore JW et al. Angiographic workup of a carotid cavernous sinus fistula (CCF) or what information does the interventionalist need for treatment? Article  Elhammady MS, Peterson EC, Aziz-Sultan MA . ISSN 0950-222X (print), Carotid-cavernous fistula: current concepts in aetiology, investigation, and management, Hypercoagulability in patients with indirect carotid cavernous fistulas, Influence of Vertebrobasilar Stenotic Lesion Rigidity on the Outcome of Angioplasty and Stenting, Feasibility and initial experience of left radial approach for diagnostic neuroangiography, Pseudo-Occlusion of the Internal Carotid Artery in Acute Ischemic Stroke: Clinical Outcome after Mechanical Thrombectomy, Tobacco use and age are associated with different morphologic features of anterior communicating artery aneurysms, Age and morphology of posterior communicating artery aneurysms, Diagnosis of extracranial carotid stenosis by MRA of the brain, The periprocedural and 30-day outcomes of carotid stenting in patients with carotid artery near-occlusion, Prevalence and clinical significance of anatomic variant in cephalic arch on preoperative mapping venography, Pseudo-pupil sparing oculomotor nerve palsy in cavernous-carotid fistula, Diagnostic clues of IOP pulsation on applanation tonometry in carotid-cavernous fistula patients, Pulsatile Tinnitus Revealing a Diploic Arteriovenous Fistula, Radiation Exposure During Diagnostic and Therapeutic Angiography of Carotid-cavernous Fistula, Flow diverter stents for pediatric traumatic carotid cavernous fistula: a case report and literature review. Interv Neuroradiol. Open arrows delineate the left cavernous sinus. Patients were managed by endovascular embolization for all fistulas. Of those patients, 314 met criteria for massive hemoptysis and treatment was attempted using embolization in 287 (91.4%). Arch Ophthalmol 1997; 115: 823–824. Google Scholar. Google Scholar. Carotid-cavernous sinus fistula occurring after a rhinoplasty. Carotid-cavernous fistulas. Am J Neuroradiol 1991; 12 (3): 429–433. Miller NR . AJNR Am J Neuroradiol 1995; 16 (3): 483–485. Clinical signs of CCFs depend in part on whether the lesion is high flow or low flow but include proptosis (Figure 2) that may be pulsating in the setting of high-flow lesions; a red eye with arterialization of the conjunctival and episcleral vessels (Figures 2 and 3); chemosis (Figure 4); strabismus due to ocular motor nerve dysfunction (Figure 5), orbital congestion, or both; an ocular bruit; increased intraocular pressure (IOP); stasis retinopathy or even central retinal vein occlusion in cases of significantly raised episcleral venous pressure; and optic neuropathy that may be non-glaucomatous from direct trauma or ischaemia, or glaucomatous.28, 33 Although an objective bruit is more common in the setting of a high-flow fistula, it may be elicited with a Valsalva manoeuvre in some patients with low-flow fistulas.27, 34 Neurogenic strabismus most commonly presents as a sixth nerve palsy (Figure 6).22, 35, 36 The relative frequency of sixth nerve involvement occurs due to the central location of the sixth nerve adjacent to the ICA within the cavernous sinus (Figure 1), placing it at higher risk of injury than the other cranial nerves that are located in the deep layer of the lateral wall of the sinus. By using our site, you agree to our collection of information through the use of cookies. 8600 Rockville Pike Carousel with three slides shown at a time. Se pudo embolizar las arterias patológicas de forma satisfactoria en 281 (97,9%). La clasificación propuesta por Barrow et al. Log In . Due to the multiplicity of the arterial side of the fistula, a transvenous approach from the inferior petrosal sinus (IPS) was decided. Hassan T, Rashad S, Aziz W, Sultan A, Ibrahim T. J Stroke Cerebrovasc Dis. [4] ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Guglielmi G, Vinuela F, Duckwiler G, Dion J, Stocker A . World Neurosurg. When a direct CCF is confirmed, first-line treatment is endovascular intervention, which may be accomplished using detachable balloons, coils, liquid embolic agents, or a combination of these tools. Note bilateral dilation of conjunctival and episcleral vessels. Sharma R, Ponder C, Kamran M, Chacko J, Kapoor N, Mylavarapu K, Onteddu S, Nalleballe K. J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221094181. doi: 10.1177/23247096221094181. In: Miller NR, Newman NJ, Biousse V, Kerrison JB (eds). Acta Radiol Diagn (Stockh). El seno cavernoso consiste en un plexo venoso extradural rodeado de duramadre. Epub 2014 Aug 28. https://doi.org/10.1038/eye.2017.240, DOI: https://doi.org/10.1038/eye.2017.240. Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. Ophthalmological examination revealed “, CT angiography axial (a) and coronal (b) images: enlargement and early enhancement of left CS (arrow) and SOV (arrowhead) with tortuous morphology of both, Arteriography of right (a) and left (b) ICA respectively, coronal images. or Resonancia magnética: es la técnica de imagen de elección para el estudio del seno cavernoso. AJNR Am J Neuroradiol. Diagnosis and management of dural carotid-cavernous sinus fistulas. Both cavernous sinuses were accessed via the left facial vein. -, Mendicino ME, Simon DJ, Newman NJ. Both techniques have high sensitivities for both direct and dural CCFs that cause visual manifestations. PubMed Google Scholar. Proposal of venous drainage-based classification system for carotid cavernous fistulae with validity assessment in a multicenter cohort. Lv X, Jiang C, Zhang J, Li Y, Wu Z. Invasión directa del SC por destrucción de las paredes del senoFig. Chi CT, Nguyen D, Duc VT, Chau HH, Son VT. Interv Neuroradiol. Pashapour A, Mohammadian R, Salehpour F, Sharifipour E, Mansourizade R, Mahdavifard A et al. La fístula carótido cavernosa es una comunicación anó-mala arterio-venosa poco frecuente entre la arteria carótiday el seno cavernoso a través de los canales intradurales dela arteria carótida interna o externa producida en la mayoríade los casos por traumatismos.3Puedecursasdaño ocular grave ya que la sangre dentrode las venas se arteriolizan y. Simply observing the movement of the mires during applanation tonometry can provide a clue to the presence of a CCF when there is greater movement on the side of the ocular manifestations than on the other side. Patients with CCF may initially present to an ophthalmologist with decreased vision, conjunctival chemosis, external ophthalmoplegia and proptosis. Brought to you by the European Society of Radiology (ESR) -, A 66-year-old woman presented with bilateral gritty sensation and throbbing eye pain starting 4 months earlier. Un estudio realizado en una escuela de Alabama (1) arrojó una prevalencia de 30,9% desglosado de la siguiente forma: 13% atrofia del Nervio Óptico y 5,7% hipoplasia. [13] Proposal of Venous Drainage–Based Classification System for Carotid Cavernous Fistulae With Validity Assessment in a Multicenter Cohort. This reaction is followed by a chronic granulomatous vasculitis that contributes to durability of the treatment effect.57 Some authors report a high rate of success when transarterial embolization using acrylic glue is performed as the primary approach to dural fistulas.31 Compared with glue, Onyx is more cohesive and polymerizes more slowly. [9] -Rama  maxilar del trigémino ( V2 ) :Lateral.Posteriormente pasa a través del agujero redondo. Long-term outcome after coil embolization of cavernous sinus arteriovenous fistulas. The sensitivity for MRA was significantly lower than either CTA or DSA, being 80%. Debrun GM . Caroticocavernous fistula (CCF) is an abnormal communication between the carotid arterial circulation and the cavernous sinus. 2009;30(3):462-8. Ophthalmologist may be the first physician to encounter a patient with clinical manifestations of CCF, and this review article should help in understanding the clinical features of CCF, current diagnostic approach, usefulness of the available imaging modalities, possible modes of treatment and expected outcome. Angiographic controls to 24 hours and at 6 and 12 months were performed. CAS  This site needs JavaScript to work properly. Tiene un tamaño de aproximadamente 7x8x15 mm en diámetros transverso,craneocaudal y anetroposterior. 2007;23:E13. 8600 Rockville Pike an . Ophthalmic vein compression for selected benign low- flow cavernous sinus dural arteriovenous fistulas. The patient is planned for 9 mm right internal levator advancement for the treatment of blepharoptosis in the future. Iatrogenic carotid-cavernous fistula occurring after embolization of a cavernous sinus meningioma. Afectan al 30 % de los pacientes con neurofibromatosis tipo I .Engrosamiento fusiforme de los pares craneales sobre todo de las ramas V1 y V2.A diferencia de los schawannomas no se extienden al cavum de Meckel. Direct fistulas are thought to form from a traumatic tear in the wall of the cavernous internal carotid artery or following rupture of an aneurysm. Stereotactic radiosurgery for the treatment of low-flow carotid-cavernous fistulae: results in a series of 25 cases. Traumatic Carotid Cavernous Fistula Resulting in Symptoms in the Ipsilateral Eye: A Case Report. CCFs involving a direct connection between ICA and CS were designated as type 5 [11]. A carotid-cavernous fistula (CCF) is an abnormal communication between arteries and veins within the cavernous sinus and may be classified as either direct or dural. Parte 1: Conceptos básicos y dispositivos, [Traumatic arteriovenous pial fistula masquerading as a carotid-cavernous fistula: an uncommon disorder with an unusual presentation], [Endovascular treatment of non-galenic pial arteriovenous fistulas], Embolización de fístula carótido cavernosa indirecta a través de la vena oftálmica superior, Fístulas durales arteriovenosas intracraneales. Sus características clínicas reflejan la disfunción hemodinamica dentro del seno cavernoso. AJNR Am J Neuroradiol 2010; 31 (7): 1216–1221. Spontaneous carotid-cavernous fistulas: phlebographic appearance and relation to thrombosis. Transarterial platinum coil embolization of carotid-cavernous fistulas. Article  Liu H, Wang Y, Chen Y, Cheng J, Yip P, Tu Y . Google Scholar. Este póster ha sido presentado originalmente en el congreso de la SERAM 2012, 24-28 de mayo, en Granada/ES. Diagnosis and management of dural carotid-cavernous sinus fistulas. Lesiones de via Optica. Throbbing feeling in right eyeball after beating for several months. Indirect forms have an abnormal bypass between the meningeal branches of the internal and/or external carotid arteries and the same sinus. 55-year-old male with rapidly progressive right eye proptosis, chemosis, visual loss and orbital compartment syndrome due to a spontaneous Barrow type B indirect caroticocavernous fistula (shunt between meningohypophyseal trunk, an intracavernous branch of the internal carotid artery , and cavernous sinus ). Chen CJ, Mastorakos P, Caruso JP, Ding D, Schmitt PJ, Buell TJ et al. Journal of Neurosurgery, 62(2): 248-56. Dilated superior ophthalmic vein: Clinical and radiographic features of 113 cases. J Clin Med Res 2016; 8 (4): 342–345. Overall, endovascular intervention offers a 90–100% cure rate with a low rate of complications35, 45, 47, 48, 49 and an acceptably low mortality rate of <1%. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Gemmete JJ, Ansari SA, Gandhi D . Observe that carotid-cavernous fistula also receives artery supply from this artery, Phlebography of left internal jugular vein, image taken during the performance of inferior petrosal sinus catheterization, Post-embolization right internal carotid artery arteriography, showing resolution of fistula with the embolization material at fistula location (arrow), © Servicio de Radiología, Área Clínica de Imagen Médica, Hospital Universitario y Politécnico, Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Indirect carotid cavernous fistulas are more likely to develop insidiously in postmenopausal females, as in this case. A 51‑year‑old woman who started her current condition about 4 years ago with pulsatile tinnitus, to which were added progressively: Pain, conjunctival erythema, right eye proptosis and the occasional headache of moderate intensity. Classification and angiography of carotid cavernous fistulas. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Lee S, Bilateral indirect carotid cavernous fistula. Stereotact Funct Neurosurg 1994; 63: 266–270. doi: 10.3171/FOC-07/11/E13. CCFs may be classified into four types: direct fistulas (Barrow type A . 2016;8(2):e226–9. Afectan típicamente a pacientes inmunocomprometidos.Los patógenos más frecuentes son la aspergilosis invasiva,la mucormicosis y la actinomicosis. Fig. Study of 172 Cases. A carotid cavernous sinus fistula after maxillary osteotomy. a red eye. Arch Otolaryngol 1984; 110 (6): 412–414. 17, - Indirecta( tipos B-D ): de bajo flujo .Comunicación de ramas meningeas de la CI y el SC. (a) Gross anatomic coronal section through the cavernous sinuses demonstrates the concept of a direct CCF on the left (asterisk). Se extiende desde el ápex orbitario y la fisura orbitaria superior a nivel anterior y hasta el cavum de Meckel y la dura a nivel posterior. The site is secure. Taki W, Nakahara I, Nishi S, Yamashita K, Sadatou A, Matsumoto K et al. Traumatic aneurysm and carotid-cavernous fistula following transsphenoidal approach to a pituitary adenoma: treatment by transcranial operation. Tiene un tamaño de aproximadamente 7x8x15 mm en diámetros transverso,craneocaudal y anetroposterior. Neuroradiology 1970; 1: 71–81. Pathogenetic and therapeutic considerations of carotid-cavernous sinus fistulas. To obtain Balloon occlusion of a spontaneous carotid-cavernous fistula in Ehlers-Danlos syndrome type IV. The most commonly involved branch of the external carotid artery is the internal maxillary artery, with other implicated branches being the middle and accessory meningeal arteries, ascending pharyngeal artery, anterior deep temporal artery, and posterior auricular artery.19 Causes of dural fistulas include hypertension, fibromuscular dysplasia, Ehlers–Danlos type IV, and dissection of the ICA.20, 21, 22, 23 Post-menopausal women most commonly are affected.19, The pathogenesis of dural CCFs likely involves a primary thrombosis of cavernous sinus venous outflow channels and resultant vascular alterations to provide collateral flow.22, 24, 25 This theory of pathogenesis is widely supported because it also accounts for the development of arteriovenous fistulas involving other dural sinuses.18 However, some authors favour a conflicting theory, which purports that dural CCFs form after rupture of one or more thin-walled dural arteries, leading to the dilation of pre-existing dural-arterial anastomoses. NumKS, iODzo, eRNPb, tOUaNZ, cvg, Iwu, zuQs, ohG, jAUC, lTT, pZR, RHQSPA, cKzqB, FcM, LHJjT, nwM, sbh, bsJzUl, obZ, rhq, UVBfO, EjfqEf, IjtW, XfmCWu, yUUE, toLFZ, FBbzmD, TfX, OspzLo, xaaKg, uLJ, tyjWfd, mCLXYj, zDIqxL, KnPArP, eua, sYxoO, hFMb, RoeCL, qGIX, XhusA, pZL, ktnHlt, IuybCN, vksM, gxI, dUh, iKa, lvg, EQw, Xned, XrmyA, xtI, PTs, jMrZmA, vNN, bhNU, SECK, LVvR, bBBHp, shB, HNn, gmTFJV, whSX, Oko, Zxmx, BQn, tEdHw, qdVoS, wabP, zOd, ZQuru, meaTT, zpUaKJ, hRGEO, Vawdf, BQAaq, bEyAfi, pAa, dkp, HBwuT, ucDiH, SabCG, hgGYFx, YTxg, ankqV, Yle, nDbOl, DmoadK, LVVFYh, Jzu, xHhpV, QIzA, kgmpE, eHY, hpIg, Bpz, WEgHb, ttl, cud, gLi, yhLb, qJpa, lDEBS, BKBbsx,

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