The ophthalmology of intracranial vascular abnormalities

Biousse, Valérie; Mendicino, Maria E.; Simon, Deborah J.; Newman, Nancy J.

doi:10.1016/s0002-9394(99)80194-9

Cited by 79 publications

(58 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…En el caso de nuestra paciente, el diagnóstico se realizó 4 meses después del evento traumático, con sintomatología progresiva que inició a la semana del mismo y gran compromiso neuro-oftalmológico, lo que no concuerda con la bibliografía en donde se describe que como regla, las fístulas directas (alto flujo) son de presentación brusca y dramática, con un desarrollo súbito de la "tríada de Dandy" que incluye exoftalmos pulsátil, soplo orbitario y quemosis conjuntival (16) aunque se han descrito periodos de hasta 8 semanas para el inicio de los síntomas (17).…”

Section: Discussionunclassified

Fistula carótido-cavernosa unilateral con síntomas neuro-oftalmológicos bilaterales e infarto cerebral venoso: Reporte de un caso.

et al. 2017

View full text Add to dashboard Cite

La fistula carótido-cavernosa es una comunicación anómala entre la arteria carótida y el seno cavernoso que provoca un shunt arteriovenoso patológico y cuyo origen es traumático o espontáneo. Las manifestaciones clínicas están relacionadas con el cambio de dirección del drenaje venoso y del flujo sanguíneo a través de la fístula e incluyen síntomas oculares tales como quemosis, exoftalmos y soplo orbitario, además de manifestaciones neurológicas como infartos venosos y hemorragias intracerebrales. Su presencia se confirma mediante la angiografía por sustracción digital (ASD) y la clasificación generalmente aceptada se basa en la propuesta por Barrow. El tratamiento endovascular ha sido el enfoque terapéutico preferido durante las últimas dos décadas; sin embargo, el tratamiento quirúrgico sigue siendo una opción cuando aquél falla o no está disponible. Se reporta el caso de una paciente de 71 años de edad, con antecedente de traumatismo cráneo-encefálico en la que se diagnósticó fístula carótido-cavernosa izquierda y síntomas neuro-oftalmológicos bilaterales asociados a un infarto venoso a nivel temporal izquierdo. La paciente fue intervenida quirúrgicamente y presentó una evolución clínica favorable.PALABRAS CLAVE: Fístula del seno cavernoso de la carótida, traumatismos de las arterias carótidas, infarto cerebral, exoftalmia. SUMMARYThe carotid-cavernous fistula is an abnormal communication between the carotid artery and the cavernous sinus that induces a pathological arterio-venous shunt, and whose origin may be traumatic or spontaneous. Its clinical symptoms are related to changes in the direction of the venous drainage and blood flow through the fistula, and include ocular symptoms as chemosis, exophthalmos and orbital murmur besides neurological manifestations such as venous infarctions and intracerebral hemorrhage. Its presence is confirmed by digital subtraction angiography and the generally accepted classification is based on Barrow'se proposal. Endovascular treatment has been the preferred treatment approach for the past two decades; however, surgical treatment remains an option when the former fails or is not possible. The case of a 71 year-old woman with a history of traumatic brain injury is reported: the patient was diagnosed with carotid-cavernous fistula and bilateral neuro-ophthalmic symptoms associated with left temporal venous infarction, and underwent surgical treatment with a favorable clinical outcome.

show abstract

Section: Discussionunclassified

Fistula carótido-cavernosa unilateral con síntomas neuro-oftalmológicos bilaterales e infarto cerebral venoso: Reporte de un caso.

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Posterior drainage via the petrosal sinuses will give less pronounced orbital symptoms. 76% of CCF are traumatic in origin 7 . The cavernous segment of the ICA is completely surrounded by a venous structure (the cavernous sinus).…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of a Large Venous Pouch Direct Carotid Cavernous Fistula

Mahmoud

El-Sissy

2013

Neuroradiol J

View full text Add to dashboard Cite

SUMMARY -Endovascular treatment of direct carotid cavernous fistula (CCF) can be performed by either arterial or venous approaches. The aim is to disconnect the fistula with or without preservation of the internal carotid artery (ICA). The aim of this article is to describe a technique for embolization of the cavernous sinus and the ICA in direct CCF using coils. Trapping the distal aspectof the fistula using a retrograde navigation via the vertebrobasilar system and the posterior communicating artery was performed in two cases. Clinical and radiological evolutions are described.

show abstract

“…Characteristic symptoms include pulsatile exophthalmos, murmur and venular dilation with chemosis (Dandy's triad) (2) . A change in the nature of the murmur may indicate improvement or a change in the drainage pattern (32,50) .…”

Section: Manifestationsmentioning

confidence: 99%

“…This method and its improvements can achieve 83% sensitivity and 100% specificity (5) . The SOV is increased in 75-100% of cases and may be the only imaging finding; it is rarely bilateral, and can even be contralateral (in cases with atypical drainage) (2,4,12) . Occasionally remissions and exacerbations can occur, which is explained by SOV thrombosis, a differential diagnosis detected by MRI (22) .…”

Section: Diagnosis and Diferential Diagnosismentioning

confidence: 99%

“…The condition typically presents with pulsating proptosis with murmur, and most cases can mimic conjunctivitis, unilateral glaucoma or Graves' disease (1,2) . The anatomical complexity of the region can be assessed by increasingly sophisticated, high-resolution neuroimaging techniques that significantly improve the accuracy of topographic diagnosis and therapeutic access (3)(4)(5)(6) .…”

mentioning

confidence: 99%

See 1 more Smart Citation