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Journal of neurosurgery · Sep 2021
Case ReportsEndoscopic endonasal transsphenoidal direct access and Onyx embolization of a dural arteriovenous fistula mimicking a carotid-cavernous fistula: case report.
- Patrick J Karas, Robert Y North, Visish M Srinivasan, Nathan R Lindquist, K Kelly Gallagher, Jan-Karl Burkhardt, Daniel Yoshor, and Peter Kan.
- 1Department of Neurosurgery and.
- J. Neurosurg. 2021 Sep 1; 135 (3): 722726722-726.
AbstractThe classic presentation of a carotid-cavernous fistula (CCF) is unilateral painful proptosis, chemosis, and vision loss. Just as the goal of treatment for a dural arteriovenous fistula (dAVF) is obliteration of the entire fistulous connection and the proximal draining vein, the modern treatment of CCF is endovascular occlusion of the cavernous sinus via a transvenous or transarterial route. Here, the authors present the case of a woman with a paracavernous dAVF mimicking the clinical and radiographic presentation of a CCF. Without any endovascular route available to access the fistulous connection and venous drainage, the authors devised a novel direct hybrid approach by performing an endoscopic endonasal transsphenoidal direct puncture and Onyx embolization of the fistula.
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