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2007, Number 2

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Med Sur 2007; 14 (2)

Uncommon association between non ruptured giant aneurysm of the internal carotid artery associated with a carotid-cavernous fistula

Roldán-Valadez E, Hernández-Martínez P, Corona-Cedillo R, Martínez-López M

Language: Spanish
References: 30
Page: 87-92
PDF size: 140.39 Kb.


ABSTRACT

Aneurysms of the intracavernous portion of the carotid artery related with carotid-cavernous sinus fistulas (CCSF’s) are not often described in the literature. If rupture they can cause a CCSF’s rather than bleeding into the subarachnoid space. Treatment of choice is the endovascular approach. Case report: A 65-year-old male developed bitemporal headache over a period of 24 hours, MR angiography and Digital Subtraction angiography depicted unruptured left-side intracavernous carotid artery aneurysms with a fistula communicating the aneurysm with the right-sided cavernous sinus; there was also projection of the aneurysm into the sphenoid sinus. Based on the classification of Barrow et al. our patient’s fistula fits as a type A fistula, this type is usually rare, with a high-speed flow associated to a traumatic event; in our patient it was spontaneous. In presenting this case, we show the MR, MR angiography and cerebral digital subtraction angiography findings of this case as well as a brief review; to the best of our knowledge the coexistence of an unruptured cavernous aneurism with a CCSF’s connected to the contralateral cavernous sinus is rarely reported.


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