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Vasospasm in the setting of traumatic bilateral carotid-cavernous fistulas and its effect on treatment

BACKGROUND: Direct, Type A, cavernous-carotid fistulas (CCFs) are predominantly caused by head trauma, especially when basilar skull fractures are present. Transarterial endovascular treatment of direct CCFs is the preferred method of treatment. Bilateral CCFs are estimated to be present in 1–2% of...

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Autores principales: Ball, Benjamin Z., Pelargos, Panayiotis E., Christie, Catherine, Golshani, Kiarash
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5791513/
https://www.ncbi.nlm.nih.gov/pubmed/29416904
http://dx.doi.org/10.4103/sni.sni_190_17
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author Ball, Benjamin Z.
Pelargos, Panayiotis E.
Christie, Catherine
Golshani, Kiarash
author_facet Ball, Benjamin Z.
Pelargos, Panayiotis E.
Christie, Catherine
Golshani, Kiarash
author_sort Ball, Benjamin Z.
collection PubMed
description BACKGROUND: Direct, Type A, cavernous-carotid fistulas (CCFs) are predominantly caused by head trauma, especially when basilar skull fractures are present. Transarterial endovascular treatment of direct CCFs is the preferred method of treatment. Bilateral CCFs are estimated to be present in 1–2% of the cases. The treatment of bilateral CCFs is difficult often requiring a combination of endovascular and open surgical approaches. CASE DESCRIPTION: We present a case of traumatic bilateral CCFs presenting with vasospasm of the anterior circulation seen on the initial angiogram on day 1 and our treatment paradigm. CONCLUSION: This case illustrates the challenges in managing bilateral CCFs as well as the changes in collateral circulation because of cerebral vasospasm which affected our treatment paradigm.
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spelling pubmed-57915132018-02-07 Vasospasm in the setting of traumatic bilateral carotid-cavernous fistulas and its effect on treatment Ball, Benjamin Z. Pelargos, Panayiotis E. Christie, Catherine Golshani, Kiarash Surg Neurol Int Neurovascular: Case Report BACKGROUND: Direct, Type A, cavernous-carotid fistulas (CCFs) are predominantly caused by head trauma, especially when basilar skull fractures are present. Transarterial endovascular treatment of direct CCFs is the preferred method of treatment. Bilateral CCFs are estimated to be present in 1–2% of the cases. The treatment of bilateral CCFs is difficult often requiring a combination of endovascular and open surgical approaches. CASE DESCRIPTION: We present a case of traumatic bilateral CCFs presenting with vasospasm of the anterior circulation seen on the initial angiogram on day 1 and our treatment paradigm. CONCLUSION: This case illustrates the challenges in managing bilateral CCFs as well as the changes in collateral circulation because of cerebral vasospasm which affected our treatment paradigm. Medknow Publications & Media Pvt Ltd 2018-01-16 /pmc/articles/PMC5791513/ /pubmed/29416904 http://dx.doi.org/10.4103/sni.sni_190_17 Text en Copyright: © 2018 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Neurovascular: Case Report
Ball, Benjamin Z.
Pelargos, Panayiotis E.
Christie, Catherine
Golshani, Kiarash
Vasospasm in the setting of traumatic bilateral carotid-cavernous fistulas and its effect on treatment
title Vasospasm in the setting of traumatic bilateral carotid-cavernous fistulas and its effect on treatment
title_full Vasospasm in the setting of traumatic bilateral carotid-cavernous fistulas and its effect on treatment
title_fullStr Vasospasm in the setting of traumatic bilateral carotid-cavernous fistulas and its effect on treatment
title_full_unstemmed Vasospasm in the setting of traumatic bilateral carotid-cavernous fistulas and its effect on treatment
title_short Vasospasm in the setting of traumatic bilateral carotid-cavernous fistulas and its effect on treatment
title_sort vasospasm in the setting of traumatic bilateral carotid-cavernous fistulas and its effect on treatment
topic Neurovascular: Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5791513/
https://www.ncbi.nlm.nih.gov/pubmed/29416904
http://dx.doi.org/10.4103/sni.sni_190_17
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