Partial steal phenomenon in the ophthalmic artery due to a direct carotid-cavernous sinus fistula: orbital color Doppler ultrasonographic findings

Objective Assessment of Arterial Steal Phenomenon in Direct Carotid Cavernous Fistula Using 2D Parametric Parenchymal Blood Flow Analysis

The aim of the study is to evaluate the hemodynamic changes and the parenchymal perfusion associated with carotid cavernous fistulas before and after embolization using two-dimensional (2D) parenchymal blood flow analysis. A 15-year-old boy presented with 2-month history of progressive right eye proptosis, chemosis, and diplopia after a motor vehicle accident. Intracranial liquid embolization using Onyx-18 through the inferior petrosal approach was done with balloon protection at the opening of the fistula in the internal carotid artery, resulting in complete occlusion of the fistula. Parenchymal blood flow analysis was done before and immediately after embolization. 2D parametric parenchymal blood flow analysis is newly introduced software that can provide data cannot be conveyed by conventional digital subtraction angiography alone. The software allows for objective assessment of the arterial steal and the parenchymal perfusion both pre, and post-embolization. Pre-embolization assessment may influence the therapeutic decision, while post-embolization assessment can evaluate the treatment efficacy.

Carotid cavernous fistula in CNS choriocarcinoma

Carotid artery-cavernous sinus fistulas (CCFs) are infrequently reported in the pediatric population, and are rarely reported in conjunction with CNS neoplasms. The authors present a 7-year-old girl with CNS choriocarcinoma who acutely developed left eye proptosis and conjunctival injection. Computed tomography angiography revealed a CCF, which was endovascularly embolized with detachable coils. There may be a direct cause-and-effect relationship between choriocarcinoma and development of CCFs.

Fístulas carótido-cavernosas. A propósito de dos casos

Carotid-cavernous fistulas are uncommon anomalous communications between the venous cavernous sinus and the carotid arterial system. We present two cases studied at our center. We show the characteristic CT, MRI, and orbital ultrasound findings and review the relevant literature.

[Carotido-cavernous fistula after traumatic brain injury: an unusual vascular complication]

The authors reported the case of a young man who suffered a cranial traumatism and showed neurological, ophthalmic and orbital signs with orbital bruit, cranial nerve palsy and chemosis while he was in the intensive care unit. Further examinations of imagery made it possible to highlight a high-flow carotid-cavernous fistula which was the origin of these symptoms and which was successfully treated by endovascular way. The aim of this article is to remind the reader of the characteristics of this pathology, in terms of epidemiology, physiopathology, clinical and paraclinical presentation, and therapeutic care.

Contralateral Total Steal Associated with Direct High-Flow Shunt Between Carotid Artery and Internal Jugular Vein after Digital Compression of Carotid artery for Posttraumatic Carotid-Cavernous Fistula: A Study of Selective Four-Vessel Angiography Findings

A 40-year-old woman was involved in a traffic accident and was admitted to another hospital with a severe head injury with a Glasgow Coma Scale score 1 of 8. Skull radiographic film showed extensive temoralbasal fracture unilaterally. Two months later, she presented with left ophthalmoplegia and exophthalmos and with chemosis 4 months after the accident.