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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(02): 376-380
DOI: 10.4103/ajns.AJNS_246_20
Case Report

Clinical improvement of patients with endovascular treatment in the traumatic carotid-cavernous fistula

Galih Permana
Department of Neurosurgery, Dr. Soetomo General Academic Hospital, Airlangga University, Surabaya
,
Nur Suroto
Department of Neurosurgery, Dr. Soetomo General Academic Hospital, Airlangga University, Surabaya
,
Asra Al Fauzi
Department of Neurosurgery, Dr. Soetomo General Academic Hospital, Airlangga University, Surabaya
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A carotid-cavernous sinus fistula (CCF) is a clinical condition when there is an abnormal communication between the internal carotid artery, external carotid artery (ECA), or any of their branches to the cavernous sinus. Traumatic CCF (TCCF) is the most common type of all CCFs. This study aims to find clinical improvement of traumatic carotid-cavernous fistulas (TCCF) after endovascular treatment. We predict the degree of clinical recovery in an attempt to make the treatment of TCCF safe and effective. This study reported a series of 28 patients with TCCFs undergoing coiling and ballooning in a period of 3 years, i.e., from December 2014 to December 2017. This is a novel case report about CCF in our country, Indonesia, especially in Surabaya. We performed clinical, angiographical, and radiological assessments before and at regular time periods after the procedure until 6 months. All patients had a partial and complete occlusion of the fistula. Angiographic occlusion of fistula, visualization of the ophthalmic artery, and disappearance of bruit predicted a good clinical outcome. All patients made a recovery at different times, depending on the degree of fistulas and treatment. Improvement in clinical symptoms had a direct correlation with the degree of occlusion. Treatment was divided into coiling and ballooning depending on patient's condition and angiographic examination. Trans femoral cerebral angiography is still very important diagnostic tool in the diagnosis and treatment of TCCFs.

Key-words:

Cavernous sinus - endovascular embolization - traumatic carotid-cavernous fistulas - trans femoral cerebral angiography

Financial support and sponsorship

Nil.




Publication History

Received: 22 May 2020

Accepted: 24 September 2020

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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