Cavernous sinus fistula caused by intracavernous rupture of a persistent primitive trigeminal artery. Case report.
A persistent carotid-basilar anastomosis (primitive trigeminal artery), identified by four-vessel vertebral angiography, was shown to be the cause of a cavernous sinus fistula in a 51-year-old woman. The fistula, but not the primitive artery, was identified on a carotid arteriogram. Because of the flow contribution from the posterior circulation, balloon embolization via the carotid system failed, and the fistula was repaired through a direct surgical approach. The operative technique is described and the hemodynamic aspects of a cavernous sinus fistula that is related to this primitive anastomosis are reviewed.
D002426:Cavernous Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D002536:Cerebral Arteries / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D012422:Rupture, Spontaneous