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Ugan Singh Meena, Pankaj Gupta, Trilochan Shrivastava, Devendra Purohit
Traumatic carotid-cavernous fistula (TCCF) is a direct communication between cavernous portion of the internal carotid artery (ICA) and cavernous sinus due to tear in ICA. Most of the cases are treated by endovascular embolization. Spontaneous resolution of high-flow TCCFs is extremely rare. We report a case of posttraumatic, direct, high-flow carotid cavernous fistula (Barrow type A) that resolved spontaneously after cerebral angiography.
April 2016: Asian Journal of Neurosurgery
Tzu-Chin Lin, Shih-Hsuan Mao, Chih-Hao Chen, Yao-Liang Chen, Ho-Fai Wong, Chee Jen Chang, Yin-Cheng Huang
OBJECTIVE: The current therapies for traumatic carotid-cavernous sinus fistula (tCCF) yield a variable rate of recurrence and produce different results. We analyzed factors among traumatic head injury to identify the risk factors in recurrent tCCFs. METHODS: We retrospectively reviewed patients who were diagnosed with tCCFs from January 2004 to December 2014 in a tertiary referral center. The factors that were analyzed included age, sex, associated injury, clinical presentation, interval from injury to interventions, interventions for tCCFs, and pathologic characters of tCCFs under digital subtraction angiography...
June 2016: World Neurosurgery
Jinlu Yu, Yunbao Guo, Shujie Zhao, Kan Xu
Brainstem edema caused by traumatic carotid-cavernous fistula (TCCF) is rare, and there is little information available regarding its clinical characteristics. The present report describes the case of a 51-year-old man with TCCF, who presented with right exophthalmos and intracranial bruit for 1 week. One month prior to admission at hospital, he fractured the frontal and ethmoid sinuses. Digital subtraction angiography confirmed the diagnosis of TCCF, and magnetic resonance imaging (MRI) suggested edema on the right side of the pons...
August 2015: Experimental and Therapeutic Medicine
Qing Huang, Hongbing Zhang, Gang Wang, Jun Yang, Yanlong Hu, Jianxin Liu
One case of traumatic carotid-cavernous fistula (TCCF) with small fistula treated by transarterial detachable coil embolization was reported. The intermittent ipsilateral carotid compression was used to identify the final blocking of the residual fistula. The follow-up digital subtraction angiography showed that the TCCF was cured finally. From this case, we conclude that this method may be an effective way to treat TCCF with small fistula.
2015: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Alexandru Chiriac, Bogdan F Iliescu, Nicolae Dobrin, Ion Poeata
Traumatic carotid-cavernous fistula (TCCF) is a rare neurovascular pathologic entity. The bilateral form occurs even rarer and given the potential risk for both optic tracts presents an urgent indication for quick and effective treatment. We present a patient with a bilateral Barrow type A TCCF with a fulminant development of symptoms, who was successfully treated with bilateral detachable balloons in a single session endovascular procedure. The patient experienced complete relief of symptoms, however the complete neurological deficit in the left optic nerve was persistent...
2014: Turkish Neurosurgery
Yan-Chao Liu, Chuan-Zhi Duan, Da-Qun Gu, Xin Zhang, Xi-Feng Li, Xu-Ying He, Shi-Xing Su, Ling-Feng Lai, Hui-Li
PURPOSE: The recovery time of traumatic carotid-cavernous fistula-induced oculomotor nerve paresis (ONP) after endovascular embolization with detachable balloons has not yet been adequately evaluated. This study was performed to make a deep analysis of the factors, which affect the prognosis of ONP after endovascular treatment of traumatic carotid-cavernous fistula (TCCF). MATERIALS AND METHODS: We retrospectively evaluated the clinical characteristics and the outcome of oculomotor nerve function in a series of 98 consecutive patients with ONP due to traumatic carotid-cavernous fistula which were endovascular treated with detachable balloons...
December 2014: Journal of Neuroradiology. Journal de Neuroradiologie
Tao Zeng, Yu-Feng Lin, Song-Sheng Shi
OBJECTIVE: To present our experience in treating traumatic carotid-cavernous fistula (TCCF) by multimodal endovascular treatment. METHODS: The management of 28 patients with TCCF between January 2004 and October 2012 in our hospital was retrospectively analyzed. According to imaging charateristics, 24 cases were categorized into Type I, 3 Type II and 1 Type III. Totally 30 endovascular treatments were performed: Type I TCCFs were obliterated via transvenous approach (7/25), or transarterial approach (18/25) including 6 by detachable balloon occlusion, 6 by microcoil embolization, 3 by Hyperglide balloon-assisted coil embolization and 3 by a combination of detachable balloon and coil embolization...
2013: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Trang Nguyen, Young Hoo Cho, Yu Jin Jang, Myong Chul Park, Seung Jun Shin
Traumatic carotid-cavernous sinus fistula (TCCF) is a rare but significant vascular abnormality in the skull base found after craniomaxillofacial trauma. Although the direct type is usually caused by trauma, the onset of symptoms in TCCF may present several weeks after injury. We present the case of a patient who sustained a blunt head injury from falling down and was hospitalized with skull base fracture associated with zygomatic complex fractures on the right side. After surgery, the recovery was uneventful and the patient was discharged without any problems...
May 2013: Journal of Craniofacial Surgery
Xiao-Quan Xu, Sheng Liu, Qing-Quan Zu, Lin-Bo Zhao, Jin-Guo Xia, Chun-Gao Zhou, Wei-Zhong Zhou, Hai-Bin Shi
BACKGROUND AND PURPOSE: This study evaluated the clinical value of detachable-balloon embolization for traumatic carotid-cavernous fistula (TCCF), focusing on the frequency, risk factors, and retreatment of recurrence. METHODS: Fifty-eight patients with TCCF underwent transarterial detachable-balloon embolization between October 2004 and March 2011. The clinical follow-up was performed every 3 months until up to 3 years postprocedure. Each patient was placed in either the recurrence group or the nonrecurrence group according to whether a recurrence developed after the first procedure...
April 2013: Journal of Clinical Neurology
Kwang-Chun Cho, Dae-Hee Seo, Il-Seung Choe, Sung-Choon Park
Bilateral traumatic carotid-cavernous fistulae (TCCFs) is rarely encountered neurovascular disease. For treatment of TCCF, detachable balloons have been widely used. Nowadays, transarterial and/or transvenous coil embolization with placement of covered stents is adopted as another treatment method. We experienced a patient with a bilateral TCCFs who was successfully treated with covered stents. However, cerebral hemorrhage occurred in the bed of previous infarction one day after treatment. Hyperperfusion syndrome was considered as a possible cause of the hemorrhage, so that barbiturate coma therapy was started and progression of hemorrhage was stopped...
August 2011: Journal of Korean Neurosurgical Society
Z Wu, Y Zhang, C Wang, X Yang, Y Li
From 1986 to the end of 1998, 482 cases of traumatic carotid-cavernous fistula (TCCF) were treated by means of intravascular embolisation technique. The experience is overviewed in this article. Many kinds of detachable balloon catheters (including Chinese made detachable balloon catheters), coils and cyanoacrylate were used as embolic materials. Transcervical, transfemoral, anterior communicating artery, posterior communicating artery approach, or transvenous approach were selected according to conditions...
December 22, 2000: Interventional Neuroradiology
Chao Bao Luo, Michae Mu Huo Teng, Chung Jung Lin, Feng Chi Chang, Cheng Yen Chang
We report our experience with transarterial embolization of traumatic carotid-cavernous fistulae (TCCFs) by using Gugliemi detachable coil (GDC). From 2000 to 2007 at our institution, 11 patients with 12 TCCFs underwent transarterial GDC embolization because of failure to occlude fistulae by detachable balloon with preservation of the parent artery. The cause of the failure to occlude the fistula by detachable balloon was small fistula tract (n=9) and/or tortuous parent artery (n=3) or repeated balloon puncture by bony fragment (n=1)...
November 11, 2008: Interventional Neuroradiology
R C Huai, C L Yi, L B Ru, G H Chen, H H Guo, L Luo
This study was designed to elucidate the generating mechanism, diagnosis and treatment of traumatic carotid cavernous fistula (tCCF) concomitant with pseudoaneurysm in the sphenoid sinus. Six cases of tCCF concomitant with pseudoaneurysm in the sphenoid sinus were analyzed in this study. Clinical history, neurological examination, CT and MRI scans, pre- and postembolization cerebral angiograms and follow-up data were included. All patients presented with massive epistaxis and symptoms of tCCF. The pseudoaneurysms and fistulas were occluded with detachable balloons, and preservation of the parent artery in two cases...
March 30, 2008: Interventional Neuroradiology
Li-zhao Chen, Min-hui Xu, Dong-hong Yang, Yong-wen Zou, Yun-dong Zhang
OBJECTIVE: To retrospectively analyze 95 cases of traumatic carotid cavernous fistula treated by endovascular embolization. METHODS: From January 1994 to December 2008, 95 patients with traumatic carotid cavernous fistula were treated in our hospital. All patients received selective cerebral angiography through femoral artery catheterization. Accordingly, 89 cases were treated by detachable balloon embolization, 5 by platinum microcoils and 1 by covered-stent, respectively...
February 2010: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Chao-Bao Luo, Michael Mu-Huo Teng, Feng-Chi Chang, Wan-Yuo Guo, Cheng-Yen Chang
BACKGROUND: Simultaneous multiple intracranial carotid injuries (ICIs) after head trauma are rarely referred for treatment and are often times fatal. The purpose of this study was to describe the potential angiographic pitfalls in diagnosis of multiple ICIs and to report the principles of endovascular management in 15 patients with 34 ICIs. METHODS: A 12-year study of the 15 patients (8 men and 7 women) with 34 ICIs was completed, and patients were managed by endovascular treatment...
December 2009: Journal of Trauma
A Kessel, J Green, R Pinder, P Wilkinson, C Grundy, K Lachowycz
OBJECTIVES: Quantitative analysis of the physical and demographic parameters of access to Thames Chase Community Forest (TCCF), and how these have changed between 1990 and 2003; and qualitative exploration of our understanding of the links between health and the natural environment (TCCF), with a focus on the issue of 'access' to green space. STUDY DESIGN: Multimethod design involving both quantitative (analysis of physical access to green space) and qualitative (ethnography) components...
January 2009: Public Health
Wen Liang, Yang Xiaofeng, Liu Weiguo, Qiu Wusi, Shen Gang, Zheng Xuesheng
BACKGROUND: Traumatic carotid cavernous fistula (TCCF) is a rare vascular complication of traumatic brain and facial injury. The purpose of this study was to analyze the incidence of this disorder in different types of basilar skull fracture, determine whether particular clinical factors impacted outcomes, and discuss ways of improving prognosis. METHOD: We performed a retrospective analysis of cases with basilar skull fracture or angiography-confirmed TCCF in inpatients between 1999 and 2005, as well as an analysis of the incidence rate of TCCF in each type of basilar skull fracture...
November 2007: Journal of Trauma
C B Luo, M M H Teng, F C Chang, M H Sheu, W Y Guo, C Y Chang
BACKGROUND: Most traumatic carotid-cavernous fistula/e (TCCF) are unilateral, and simultaneous bilateral TCCF are uncommon. The purpose of this study was to evaluate the angiographic architecture of bilateral TCCF and report our experience with their endovascular management. METHOD: Over 15 years, 252 consecutive patients with TCCF were referred to our institute for endovascular treatment. Bilateral TCCF occurred in 5 men and 2 women with a mean age of 31 years...
2007: Acta Neurochirurgica
Chao-Bao Luo, Michael Mu-Huo Teng, Feng-Chi Chang, Cheng-Yen Chang
Traumatic carotid-cavernous fistula (TCCF) is a direct shunting fistula due to a tear in the cavernous portion of the internal carotid artery (ICA). Spontaneous thrombosis of the high-flow shunts in TCCFs is extremely rare. Most cases are treated using endovascular embolization to relieve the clinical presentations. We report 2 unusual cases of TCCF with spontaneous closure of fistulas at intervals of 2 and 10 days, respectively, after diagnostic angiograms. The possible mechanisms of spontaneous healing of the fistulas in these patients with minor head injury and small fistulas were presumed to be a transient decrease in fistula blood flow because of irritation of and/or subtle injury to the ICA by contrast media and/or catheter during diagnostic angiogram, with thrombosis formation at the fistula...
October 2005: Journal of the Chinese Medical Association: JCMA
Zhengjian Feng, Jianwen Li, Xiao Ding
PURPOSE: To detect the value of digital subtraction angiography (DSA) and intra-vessel embolism in diagnosing and treating traumatic carotid-cavernous fistula (TCCF). METHOD: 9 cases with TCCF characteristic of pulsating exophthalmos, who were checked by DSA and treated by detachable balloon technique, were analyzed retrospectively. RESULT: Carotid-cavernous fistula of these patients was observed with DSA and occluded with intra-vessel embolism successfully...
June 2002: Yan Ke Xue Bao, Eye Science
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