Is carotid cavernous fistula an emergency?
Is carotid cavernous fistula an emergency?
Introduction. A carotid-cavernous sinus fistula (CCF) is a rare condition well known in the neurosurgical field, but not well published in emergency medicine literature. Whether post-traumatic or spontaneous in nature, the symptoms related to CCFs are insidious and potentially severe.
What is carotid cavernous sinus fistula?
Carotid-cavernous fistula (CCF) is an abnormal connection between the carotid artery and/or its branches and a large vein called the cavernous sinus. The cavernous sinus is located behind the eye and receives blood from brain, orbit, and pituitary gland.
How is a carotid cavernous fistula diagnosed?
Carotid cavernous fistulas can be diagnosed by imaging studies such as:
- CT scan.
- MRI scan.
- Angiogram.
What are cavernous carotids?
A carotid-cavernous sinus fistula (CCF) is an abnormal connection between an artery in your neck and the network of veins at the back of your eye. These veins at the back of your eye transport blood from your face and brain back to your heart and are located in small spaces behind your eyes called cavernous sinuses.
How is CC fistula treated?
Treating a carotid cavernous fistula with embolization involves placing small platinum coils where the abnormal connection is. This separates the blood flow of the carotid arteries from that of the veins. As a result, the blood can drain properly from the eyes. Coil embolization is done in an angiography suite.
Is carotid-cavernous fistula painful?
Carotid-cavernous fistula (CCF) is a rare cause of painful ophthalmoplegia, and early diagnosis is quite difficult.
What are the main clinical signs of direct carotid-cavernous fistula?
Signs and symptoms Direct carotid-cavernous fistulas are characterized by the triad of pulsatile proptosis, chemosis, and intracranial whistling. There is severe conjunctival congestion, hemorrhagic chemosis, ptosis, and pulsatile proptosis accompanied by a whistling.
What are the main clinical signs of direct carotid cavernous fistula?
Is the cavernous sinus part of the brain?
The cavernous sinus within the human head is one of the dural venous sinuses creating a cavity called the lateral sellar compartment bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica….Cavernous sinus.
| Cavernous | |
|---|---|
| TA2 | 4860 |
| FMA | 50772 |
| Anatomical terminology |
What is sinus and fistula?
A fistula is an abnormal passage between a hollow organ and the skin surface, or between two hollow organs¹. “A wound sinus is a discharging blind-ended tract that extends from the surface of an organ to an underlying area or abscess cavity”. The cause of a sinus must always be determined by in-depth assessment.
What causes eye fistula?
It is a hole or tear in a branch of your carotid artery inside the cavernous sinus. This tear is called a fistula, and it is usually caused by accident or injury, including: Being hit in the head.
Which is the best treatment for carotid cavernous sinus fistula?
Carotid cavernous sinus fistulas (CCFs) are abnormal communications between the carotid arterial system and the cavernous sinus. Recent advances in endovascular techniques have resulted in several therapeutic modalities becoming available and the endovascular approach has evolved as the primary treatment option for the management of CCFs.
Can a carotid fistula be treated with a stent?
In these patients, stent-assisted coiling was a useful technique for the treatment of their type A carotid cavernous fistulas associated with severe laceration of the internal carotid artery. It should be considered as an alternative to parent artery occlusion in patients with such fistulas.
How are carotid cavernous fistulas ( CCFs ) classified?
CCFs can be classified by anatomy (direct or dural), etiology (traumatic or spontaneous) or blood flow velocity (high or low). Carotid cavernous fistulas are usually unilateral, although they may occasionally occur bilaterally or produce bilateral signs.
Which is fistula feeds the internal carotid artery?
Type A fistulas are direct communications between the internal carotid artery (ICA) and the cavernous sinus, usually associated with high flow rates. Indirect fistulas (types B, C and D) are dural arteriovenous fistulas fed by the meningeal arteries of the ICA, the external carotid artery (ECA), or both.