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Persistent primitive trigeminal artery cavernous sinus fistula coexisting with left vertebral artery dissecting
Cheng-Cai Wen1, Rui-Shu Jiang2, Shi-Jie Wen3
1Department of Neurosurgery, the Second Hospital of Longyan, China.
Abstract:
A 41-years-old woman presented with left-sided headache, diplopia, and ptosis of the left eyelid. Cerebral computed tomography angiography revealed a left persistent primitive trigeminal artery cavernous sinus fistula and a dissecting aneurysm in the V4 segment of the left vertebral artery. Digital subtraction angiography confirmed the diagnosis. The fistula was successfully occluded using dual-microcatheter coil embolization combined with Onyx-18 injection, assisted by balloon protection of the internal carotid artery. The vertebral artery dissecting aneurysm was managed conservatively by administering dual antiplatelet therapy (aspirin (100 mg/day) and clopidogrel (75 mg/day) for 3 months). Follow-up imaging at 11 months demonstrated complete resolution of the aneurysm.
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