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Posttraumatic Trigeminal-Cavernous Fistula.

Chang Wei Zhang1, Ting Wang1, Seidu A Richard2

  • 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China.

World Neurosurgery
|May 27, 2018
PubMed
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A rare case of posttraumatic trigeminal-cavernous fistula was successfully treated with Onyx embolization. This case highlights the importance of tailored treatment for complex fistulas involving persistent trigeminal artery anatomy.

Area of Science:

  • Vascular Surgery
  • Interventional Neuroradiology
  • Neuroscience

Background:

  • Persistent trigeminal artery (PTA) is the most common embryonic connection between the vertebrobasilar and carotid circulations.
  • Posttraumatic trigeminal-cavernous fistulas are exceptionally rare in medical literature.

Observation:

  • A 47-year-old male patient presented with a posttraumatic trigeminal-cavernous fistula.
  • The fistula involved a unique fistulous orifice and Salzmann type 2 anatomy.

Findings:

  • The patient was treated using Onyx embolization, a minimally invasive endovascular technique.
  • Successful occlusion of the fistula was achieved, preserving neurological function.

Implications:

  • This case underscores the necessity of individualized treatment strategies for complex dural arteriovenous fistulas.
Keywords:
CoilFistulaOnyxPTAPosttraumaticTrigeminal-cavernous

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  • Embolization of the persistent trigeminal artery and cavernous sinus may be required in specific anatomical variations.
  • Onyx embolization offers a viable treatment option for rare and complex vascular malformations.