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Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer

Infratentorial cerebral hemorrhage due to a direct carotid–cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 day...

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Autores principales: Kamio, Yoshinobu, Hiramatsu, Hisaya, Kamiya, Mika, Yamashita, Shuhei, Namba, Hiroki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Neurosurgical Society 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223754/
https://www.ncbi.nlm.nih.gov/pubmed/28061497
http://dx.doi.org/10.3340/jkns.2015.1206.001
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author Kamio, Yoshinobu
Hiramatsu, Hisaya
Kamiya, Mika
Yamashita, Shuhei
Namba, Hiroki
author_facet Kamio, Yoshinobu
Hiramatsu, Hisaya
Kamiya, Mika
Yamashita, Shuhei
Namba, Hiroki
author_sort Kamio, Yoshinobu
collection PubMed
description Infratentorial cerebral hemorrhage due to a direct carotid–cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS). Her previous surgery had sacrificed the pterygoid plexus and facial vein. Increased blood flow and reduced drainage could have led to increased venous pressure in infratentorial veins, including the petrosal and cerebellar veins. The cavernous sinus has several drainage routes, but the SPS is one of the most important routes for infratentorial venous drainage. Stenosis or absence of the posterior segment of the SPS can also result in increased pressure in the cerebellar and pontine veins. We emphasize that a direct CCF with cortical venous reflux should be precisely evaluated to determine the hemodynamic status and venous drainage from the cavernous sinus.
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spelling pubmed-52237542017-01-11 Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer Kamio, Yoshinobu Hiramatsu, Hisaya Kamiya, Mika Yamashita, Shuhei Namba, Hiroki J Korean Neurosurg Soc Case Report Infratentorial cerebral hemorrhage due to a direct carotid–cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS). Her previous surgery had sacrificed the pterygoid plexus and facial vein. Increased blood flow and reduced drainage could have led to increased venous pressure in infratentorial veins, including the petrosal and cerebellar veins. The cavernous sinus has several drainage routes, but the SPS is one of the most important routes for infratentorial venous drainage. Stenosis or absence of the posterior segment of the SPS can also result in increased pressure in the cerebellar and pontine veins. We emphasize that a direct CCF with cortical venous reflux should be precisely evaluated to determine the hemodynamic status and venous drainage from the cavernous sinus. Korean Neurosurgical Society 2017-01 2016-12-29 /pmc/articles/PMC5223754/ /pubmed/28061497 http://dx.doi.org/10.3340/jkns.2015.1206.001 Text en Copyright © 2017 The Korean Neurosurgical Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kamio, Yoshinobu
Hiramatsu, Hisaya
Kamiya, Mika
Yamashita, Shuhei
Namba, Hiroki
Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer
title Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer
title_full Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer
title_fullStr Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer
title_full_unstemmed Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer
title_short Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer
title_sort cerebellar hemorrhage due to a direct carotid–cavernous fistula after surgery for maxillary cancer
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223754/
https://www.ncbi.nlm.nih.gov/pubmed/28061497
http://dx.doi.org/10.3340/jkns.2015.1206.001
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