Giant Carotid-Cavernous Fistula with Complete Shunt

Area of Science:

• Neurology
• Vascular Surgery
• Interventional Radiology

Background:

• Carotid-cavernous fistulas (CCFs) are abnormal connections between the carotid artery and the cavernous sinus.
• Symptoms include pulsatile exophthalmos, bruit, and potential vision loss.
• Previous head trauma surgery can be a risk factor.

Purpose of the Study:

• To report a case of successful treatment of a right-sided carotid-cavernous fistula using spring coil embolization.
• To highlight the diagnostic findings and therapeutic outcomes.

Main Methods:

• Diagnosis was confirmed via angiography, revealing direct blood flow from the right internal carotid artery into the cavernous sinus.
• Treatment involved minimally invasive spring coil embolization.
• Patient underwent a comprehensive preoperative assessment.

Main Results:

• Angiography demonstrated a right-sided carotid-cavernous fistula with characteristic venous drainage patterns.
• Spring coil embolization led to the complete resolution of pulsatile exophthalmos and intracranial murmur.
• Follow-up at three months showed sustained symptom relief and absence of abnormal vascular sounds.

Conclusions:

• Spring coil embolization is an effective treatment for carotid-cavernous fistulas.
• This minimally invasive approach offers a favorable outcome for patients with CCF.
• Prompt diagnosis and intervention are crucial for managing CCF and preventing complications.