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Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
[Venous infarction associated with carotid-cavernous fistula]
Sachiko Ohshima1, Hiroshi Shigeto, Masakazu Kawajiri
1Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University.
Rinsho Shinkeigaku = Clinical Neurology
|June 14, 2006
Summary
A rare case of venous infarction occurred in an 88-year-old woman with a carotid-cavernous fistula (CCF). Dilated cortical veins in CCF patients indicate a higher risk for cerebral infarction and hemorrhage.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Carotid-cavernous fistulas (CCF) are abnormal connections between the carotid artery and the cavernous sinus.
- While intracranial hemorrhage is a known complication of CCF, venous infarction is exceptionally rare.
Observation:
- An 88-year-old woman presented with diplopia, abducens palsy, exophthalmos, and left eye congestion.
- Brain CT revealed left eye extrusion, dilated superior orbital and cerebral cortical veins, consistent with CCF.
- A separate ethmoidal sinus mass was biopsied under local anesthesia.
Findings:
- Post-biopsy, the patient developed fever, deteriorated consciousness, and right hemiparesis.
- MRI FLAIR revealed extensive high signal lesions in the left cerebral hemisphere and brainstem, indicative of venous infarction.
- Findings suggested venous infarction possibly exacerbated by peri-operative infection and hypovolemia.
Implications:
- Patients with CCF exhibiting dilated cortical veins face an elevated risk of cerebral hemorrhage or infarction.
- Close monitoring is crucial for CCF patients with signs of venous engorgement.
- This case highlights the rare but severe neurological complications associated with CCF.
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