Combined Endovascular and Endoscopic Approach for Treatment of Concomitant Sphenoid Sinus Giant Traumatic Aneurysm and Direct Carotid Cavernous Fistulas.
Adult
Carotid Artery, Internal
/ diagnostic imaging
Carotid-Cavernous Sinus Fistula
/ diagnostic imaging
Cerebral Angiography
Computed Tomography Angiography
Endovascular Procedures
/ methods
Epistaxis
/ etiology
Exophthalmos
/ etiology
Head Injuries, Closed
/ complications
Humans
Imaging, Three-Dimensional
Intracranial Aneurysm
/ diagnostic imaging
Male
Neuroendoscopy
/ methods
Sphenoid Sinus
Tomography, X-Ray Computed
Vision Disorders
/ etiology
Direct carotid cavernous fistulas
Endoscopic
Endovascular
Sphenoid sinus traumatic aneurysm
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
14
09
2019
revised:
20
10
2019
accepted:
21
10
2019
pubmed:
5
11
2019
medline:
11
3
2020
entrez:
4
11
2019
Statut:
ppublish
Résumé
Direct carotid cavernous fistulas (CCFs) and sphenoid sinus traumatic aneurysms are well-known pathologies that can present concomitantly in rare cases. Patients with both lesions are usually symptomatic from both the CCF and the traumatic aneurysm. Symptoms include proptosis, chemosis, bruit, epistaxis, visual field defects, and loss of vision. Surgical treatment can be challenging, and for most cases an endovascular approach is the treatment of choice. We present an unusual case of a direct CCF with an associated large traumatic aneurysm in the sphenoid sinus due to a history of trauma presenting with unusual symptoms that was treated by a combined endoscopic and endovascular approach. Concurrent occurrence of a traumatic CCF and traumatic aneurysm of the cavernous segment is extremely rare. Early diagnosis and treatment of these lesions are important considering their high mortality rate. Complete occlusion of the fistula and aneurysm while preserving the patency of the carotid artery via an endovascular approach is the treatment of choice for these lesions.
Sections du résumé
BACKGROUND
BACKGROUND
Direct carotid cavernous fistulas (CCFs) and sphenoid sinus traumatic aneurysms are well-known pathologies that can present concomitantly in rare cases. Patients with both lesions are usually symptomatic from both the CCF and the traumatic aneurysm. Symptoms include proptosis, chemosis, bruit, epistaxis, visual field defects, and loss of vision. Surgical treatment can be challenging, and for most cases an endovascular approach is the treatment of choice.
CASE DESCRIPTION
METHODS
We present an unusual case of a direct CCF with an associated large traumatic aneurysm in the sphenoid sinus due to a history of trauma presenting with unusual symptoms that was treated by a combined endoscopic and endovascular approach.
CONCLUSIONS
CONCLUSIONS
Concurrent occurrence of a traumatic CCF and traumatic aneurysm of the cavernous segment is extremely rare. Early diagnosis and treatment of these lesions are important considering their high mortality rate. Complete occlusion of the fistula and aneurysm while preserving the patency of the carotid artery via an endovascular approach is the treatment of choice for these lesions.
Identifiants
pubmed: 31678447
pii: S1878-8750(19)32759-7
doi: 10.1016/j.wneu.2019.10.131
pii:
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
211-214Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.