title: Spontaneous carotid-cavernous fistulae in Ehlers-Danlos syndrome Type IV. Case report.
abstract: Spontaneous bilateral carotid-cavernous fistulae and cervical artery dissection is reported in a 20-year-old woman with Ehlers-Danlos syndrome Type IV. The clinical features of 16 previously published cases of spontaneous carotid-cavernous fistulae associated with Ehlers-Danlos syndrome Type IV are reviewed, for a total of 17 cases. The mean age of the 14 women and three men was 31.6 years. Only direct fistulae were encountered. Diagnostic neuroangiography carried morbidity and mortality rates of 36% and 12%, respectively; neuroradiological treatment resulted in death in one of six patients. The possible value of desmopressin in the management of these patients is discussed. In view of the risks of arterial puncture and surgery, the authors emphasize the importance of early recognition of Ehlers-Danlos syndrome.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: W I
authors.initials: WI
authors.lastname: Schievink
authors.forename: D G
authors.initials: DG
authors.lastname: Piepgras
authors.forename: F
authors.initials: F
authors.lastname: Earnest
authors.forename: H
authors.initials: H
authors.lastname: Gordon
mesh_terms: D000328:Adult; D001164:Arteriovenous Fistula / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D002426:Cavernous Sinus / Q000000981:diagnostic imaging*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D004535:Ehlers-Danlos Syndrome / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D011859:Radiography
chemical_list: D003894:Deamino Arginine Vasopressin