Concomitant occurrence of clinoid and cavernous segment aneurysms complicated with carotid cavernous fistula: A case report

A case report of multi-step management of extracranial carotid artery aneurysm and carotid-cavernous fistula combination in patients

Extracranial carotid artery aneurysms (ECAA) and carotid-cavernous fistulas (CCF) are rare arterial pathologies with severe complications and increased risk of mortality. The optimal treatment approach for this combined condition is a topic of debate among neurosurgeons and neuroradiologists, and a standardized treatment protocol has yet to be established. The aim of this case report was to demonstrate the management of a rare combination of ECAA and CCF in patients. The treatment strategy included a two-step procedure of endovascular embolization of CCF followed by dual antiplatelet therapy and endovascular stenting of an aneurysm. Control angiograms showed the exclusion of an aneurysm from the blood circulation and CCF symptoms were resolved.

Interventional treatment of traumatic carotid-cavernous fistula: A case report

RATIONALE

Patients with traumatic carotid-cavernous fistula (TCCF) usually go to the ophthalmology department first because of the symptoms such as protrusion of eyes, edema and congestion of combined membrane, vision loss and so on. It is easy to be misdiagnosed and missed.

PATIENT CONCERNS

We report a case of left eye swelling and vision loss caused by TCCF after head injury due to traffic accident, which failed to respond to ophthalmic treatment for many times. The similar situation is very likely to cause panic among patients.

DIAGNOSIS

Cerebral angiography revealed left internal carotid-cavernous fistula (high flow type).

INTERVENTIONS

Left internal carotid artery covered stent implantation was performed.

OUTCOMES

The fistulas and the original venous mass were completely covered by the covered stent, and the development of the vascular mass disappeared. The patient's eye symptoms basically disappeared 14 days after the operation.

LESSONS

Interventional treatment of TCCF is effective.