Combined Endovascular and Endoscopic Approach for Treatment of Concomitant Sphenoid Sinus Giant Traumatic Aneurysm and Direct Carotid Cavernous Fistulas

Ghorbani, M. and Griessenauer, C.J. and Wipplinger, C. and Abdolhoseinpour, H. and Bahrami, R. and Asaadi, S. and Mortazavi, A. (2020) Combined Endovascular and Endoscopic Approach for Treatment of Concomitant Sphenoid Sinus Giant Traumatic Aneurysm and Direct Carotid Cavernous Fistulas. World Neurosurgery, 134. pp. 211-214.

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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: 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: 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. © 2019 Elsevier Inc.

Item Type: Article
Additional Information: cited By 0
Uncontrolled Keywords: adult; aneurysm; Article; blunt trauma; carotid cavernous fistula; case report; cavernous sinus; clinical article; computed tomographic angiography; computer assisted tomography; digital subtraction angiography; early diagnosis; endoscopic surgery; endovascular surgery; epistaxis; exophthalmos; eye; follow up; head injury; human; male; medical history; mortality rate; nuclear magnetic resonance imaging; paranasal sinus disease; posterior communicating artery; sphenoid; sphenoid sinus traumatic aneurysm; traumatic brain injury; vertebral arteriography; visual field defect; visual impairment; brain angiography; carotid cavernous fistula; complication; diagnostic imaging; endovascular surgery; epistaxis; exophthalmos; internal carotid artery; intracranial aneurysm; neuroendoscopy; procedures; sphenoid sinus; three-dimensional imaging; visual disorder; x-ray computed tomography, Adult; Carotid Artery, Internal; Carotid-Cavernous Sinus Fistula; Cerebral Angiography; Computed Tomography Angiography; Endovascular Procedures; Epistaxis; Exophthalmos; Head Injuries, Closed; Humans; Imaging, Three-Dimensional; Intracranial Aneurysm; Male; Neuroendoscopy; Sphenoid Sinus; Tomography, X-Ray Computed; Vision Disorders
Subjects: WG Cardiovascular System
Depositing User: eprints admin
Date Deposited: 05 Sep 2020 05:58
Last Modified: 05 Sep 2020 05:58

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