Traumatic carotid-cavernous fistula at the anterior ascending segment of the internal carotid artery in a pediatric patient

Paiva, Wellingson Silva; Andrade, Almir Ferreira de; Beer‐Furlan, André; Neville, Iuri Santana; Noleto, Gustavo; Bernardo, Luca; Caldas, José Guilherme Mendes Pereira; Teixeira, Manoel Jacobsen

doi:10.1007/s00381-013-2303-5

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…3,13 Traumatic fistulas, such as type A (direct) fistula, are most often due to head trauma associated with craniofacial trauma and skull base fracture. 6,7 Our patient, a 2-year-old girl, was younger than all previously reported cases (►Table 1). She presented with chemosis, proptosis caused by venous engorgement and palsy of the third cranial nerve, and orbital murmur caused by the arterial flow in the superior ophthalmic vein.…”

Section: Discussionmentioning

confidence: 59%

“…Traumatic carotid-cavernous fistula (TCCF) is a very rare occurrence in the pediatric population, with a frequency of 0.2 to 0.3% after craniofacial trauma, and increasing up to 4% following skull base fractures. 3 5 6 Despite its rare occurrence, TCCF reported in children can be accompanied by drastic consequences such as intracerebral hemorrhage, de novo aneurysm formation, and irreversible vision loss or ophthalmoplegia. 6 7 Due to the high vulnerability of pediatric patients, the TCCF's neurological sequelae are associated with higher burden of visual disability and potential mortality in this population.…”

Section: Introductionmentioning

confidence: 99%

“…3 5 6 Despite its rare occurrence, TCCF reported in children can be accompanied by drastic consequences such as intracerebral hemorrhage, de novo aneurysm formation, and irreversible vision loss or ophthalmoplegia. 6 7 Due to the high vulnerability of pediatric patients, the TCCF's neurological sequelae are associated with higher burden of visual disability and potential mortality in this population.…”

Section: Introductionmentioning

confidence: 99%

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Challenging Management of an Acute Traumatic Carotid-Cavernous Fistula in a 2-Year-Old Child with Literature Review

Solis,

Macha,

Toledo

et al. 2023

Indian Journal of Neurosurgery

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Traumatic carotid-cavernous fistula (TCCF) is a rare occurrence in the pediatric population. However, the neurological sequelae of TCCF are associated with higher morbidity and mortality in pediatric patients. We report the case of a 2-year-old child with TCCF treated at a public hospital in Peru. The etiology of the injury was due to a fall of approximately 5 meters. The diagnosis was made based on the clinical picture and neuroimaging findings. The initial proposed treatment was performed with the hope of preserving the parent artery; however, due to persistence of the TCCF, embolization of the parent artery with coils and embolizing substance was performed. A literature review of similar cases was performed and identified eight cases in children under 10 years of age. Endovascular management of an acute TCCF is a challenge due to the high morbidity and mortality during the acute phase and can be complicated when other traumatic injuries are present. Maintaining the parent artery is important; however, when this is not possible, trapping the parent artery may provide an alternate option when appropriate collaterals exist.

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Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Challenging Management of an Acute Traumatic Carotid-Cavernous Fistula in a 2-Year-Old Child with Literature Review

Solis,

Macha,

Toledo

et al. 2023

Indian Journal of Neurosurgery

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“…We reviewed the literature on posttraumatic CCF in pediatric patients aged 10 years or younger (Table 1) and found that Barburoglu et al reported two pediatric cases of CCF treated with flow diverter stents but gave no details about their age [1]. Only seven traumatic CCF cases in patients aged 10 years or younger who were treated with other methods have been reported [12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Flow diverter stents for pediatric traumatic carotid cavernous fistula: a case report and literature review

et al. 2021

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A 10-year-old, male patient with a head injury caused by a fall presented with chemosis, exophthalmos, right orbital bruit, and intracranial venous reflux, based on which posttraumatic carotid cavernous fistula (CCF) was diagnosed. Coil embolization was semi-urgently performed for the dangerous venous drainage. After the treatment, right abducens nerve palsy newly appeared. To treat the neurological symptoms and preserve the parent artery, curative endovascular treatment using a pipeline embolization device (PED) with coil embolization was performed after starting dual antiplatelet therapy (DAPT). The CCF and abducens nerve palsy finally resolved, and the internal carotid artery (ICA) was remodeled. Use of the PED with adjunctive coil embolization was effective and safe in the present case of pediatric traumatic direct CCF.

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“…Rangel-Castilla et al, 2014 [38] Retrospective [34] Case Report [12] Retrospective review between 1998 and 2011 2012 [14] Berker et al, 2012 [2] Case 2011 [44] Case Report [22] Case Report 2009 [39] Case report 2008 [3] Case report [5] Case report 2007 [26] Case series…”

Section: Patient Outcome Commentsmentioning

confidence: 99%

Classification of internal carotid artery injuries during endoscopic endonasal approaches to the skull base

Bafaquh¹,

Khairy

AlYamany³

et al. 2020

Surgical Neurology International

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Background: Internal carotid artery (ICA) injuries are a major complication of endoscopic endonasal approaches (EEAs), which can be difficult to manage. Adding to the management difficulty is the lack of literature describing the surgical anatomical classification of these types of injuries. This article proposing a novel classification of ICA injuries during EEAs. Methods: The classification of ICA injuries during EEAs was generated from the review of the literature and analysis of the main author observation of ICA injuries in general. All published cases of ICA injuries during EEAs in the literature between January 1990 and January 2020 were carefully reviewed. We reviewed all patients’ demographic features, preoperative diagnoses, modes of injury, cerebral angiography results, surgical and medical management techniques, and reported functional outcomes. Results: There were 31 papers that reported ICA injuries during EEAs in the past three decades, most studies did not document the type of injury, and few described major laceration type of it. From that review of the literature, we classified ICA injuries into three main categories (Types I-III) and six sub-types. Type I is ICA branch injury, Type II is a penetrating injury to the ICA, and Type III is a laceration of the ICA wall. The functional neurological outcome was found to be worse with Type III and better with Type I. Conclusion: This is a novel classification system for ICA injuries during EEAs; it defines the patterns of injury. It could potentially lead to advancements in the management of ICA injuries in EEAs and facilitate communication to develop guidelines.

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Traumatic carotid-cavernous fistula at the anterior ascending segment of the internal carotid artery in a pediatric patient

Abstract: It is important to keep a high degree of suspicion for CCF, especially in traumatic head injury associated with skull base fracture, since the early diagnosis and treatment may prevent potentially permanent neurological deficits.

Cited by 5 publications

References 21 publications

Challenging Management of an Acute Traumatic Carotid-Cavernous Fistula in a 2-Year-Old Child with Literature Review

Challenging Management of an Acute Traumatic Carotid-Cavernous Fistula in a 2-Year-Old Child with Literature Review

Flow diverter stents for pediatric traumatic carotid cavernous fistula: a case report and literature review

Classification of internal carotid artery injuries during endoscopic endonasal approaches to the skull base

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