Carotid-Cavernous Fistula Caused by Rupture of Persistent Primitive Trigeminal Artery Trunk Aneurysm-Case Report-

Yoshida, Masahiro; Ezura, Masayuki; Mino, Masaki

doi:10.2176/nmc.51.507

Cited by 18 publications

(10 citation statements)

References 21 publications

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“…Including our case, only 10 cases of spontaneous CCF associated with ruptured PPTA aneurysms were reported in the English literature (Table 1). [5][6][7][8][9][10][11][12] In seven of the 10 cases, aneurysms originated from the PPTA trunk. In addition, most of the PPTA type was classified as Saltzman type 2, in which the BA proximal to the joint of the PPTA is well developed and there are posterior communicating arteries.…”

Section: Discussionmentioning

confidence: 99%

Carotid-cavernous Fistula Associated with a Ruptured Persistent Primitive Trigeminal Artery Aneurysm: A Case Report and Review of Literature

Shiomi

Yamao

Ishii

et al. 2021

NMC Case Report Journal

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Carotid-cavernous sinus fistula (CCF) caused by a ruptured aneurysm of the persistent primitive trigeminal artery (PPTA) is rarely reported. A 69-year-old woman presented with progressive ptosis and pulsating tinnitus. Vertebral angiography under flow control of the internal carotid artery revealed CCF associated with a ruptured PPTA-trunk aneurysm, and PPTA was divided into Saltzman type 2. Endovascular treatment was performed by coil embolization of the aneurysm and parent artery occlusion of the PPTA, preserving the basilar artery (BA) side of PPTA, without complications. In the case of ruptured aneurysms originating from the Saltzman type 2 PPTA trunk, parent artery occlusion of the PPTA might be a treatment option and preservation of the BA side of PPTA is necessary to avoid ischemic complication of pons.

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Section: Discussionmentioning

confidence: 99%

Carotid-cavernous Fistula Associated with a Ruptured Persistent Primitive Trigeminal Artery Aneurysm: A Case Report and Review of Literature

Shiomi

Yamao

Ishii

et al. 2021

NMC Case Report Journal

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“…4,10 Histological abnormalities of the PPTA wall, however, are yet to be described. 11 The role of minor trauma as a precursor to fistula formation is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Coils are more commonly deployed trans-arterially, and this is the preferred approach with an underlying aneurysm. 11 In the absence of an aneurysm or in the case of a tortuous PPTA, the inferior petrosal sinus access route is suitable. 2,3,9,14,15 This approach can be difficult to obtain perfect closure leading to increased risk of venous infarction but it is usually achieved by coiling of the first venous pouch.…”

mentioning

confidence: 99%

Spontaneous direct carotid-cavernous sinus fistula secondary to a persistent primitive trigeminal artery treated by trans-venous coil embolisation

2018

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A healthy 51-year-old female presented with a spontaneous direct carotid-cavernous sinus fistula associated with a persistent primitive trigeminal artery. She had no history of connective tissue or cerebrovascular disorders or significant head trauma. This is a rare lesion with only 18 previously reported cases. It had similar clinical presentation and imaging appearance to a high-flow direct carotid-cavernous fistula and was uncovered after successful trans-venous coil embolisation of the fistula. It therefore needs to be considered in cases of direct carotid-cavernous fistula without history of trauma. Knowledge of types of persistent primitive trigeminal artery is also important for their critical treatment implications.

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“…The majority of reported cases of trigemino-cavernous fistulas have involved a Saltzman type 2 PTA, which some have argued should be preserved given its potential supply to the brainstem and trigeminal nerve 6 8. However, the PTA was preserved in only 15 of 32 treated patients (47%).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and management of trigemino-cavernous fistulas: case reports and review of the literature

Miller

Jindal

Mohan

et al. 2014

J NeuroIntervent Surg

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Although usually asymptomatic, a persistent trigeminal artery (PTA) can rarely be associated with a direct fistula to the cavernous sinus (ie, trigemino-cavernous fistula). We present three patients with trigemino-cavernous fistulas; two were subsequently treated using modern endovascular techniques while the third initially declined therapy. We then review the literature of reported cases of this unusual entity. The aberrant anatomy associated with a PTA presents unique challenges to the management of these lesions, and must be well delineated prior to treatment. Finally, conservative management of trigemino-cavernous fistulas, either de novo or recurrent, may be considered if they demonstrate no evidence of cortical venous reflux and patient symptoms are tolerable.

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Carotid-Cavernous Fistula Caused by Rupture of Persistent Primitive Trigeminal Artery Trunk Aneurysm-Case Report-

Cited by 18 publications

References 21 publications

Carotid-cavernous Fistula Associated with a Ruptured Persistent Primitive Trigeminal Artery Aneurysm: A Case Report and Review of Literature

Carotid-cavernous Fistula Associated with a Ruptured Persistent Primitive Trigeminal Artery Aneurysm: A Case Report and Review of Literature

Spontaneous direct carotid-cavernous sinus fistula secondary to a persistent primitive trigeminal artery treated by trans-venous coil embolisation

Diagnosis and management of trigemino-cavernous fistulas: case reports and review of the literature

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