Management of spontaneous carotid-cavernous fistulae.
Fifteen cases of spontaneous carotid-cavernous fistulae, including 4 patients with spontaneous cure and 8 treated with electrothrombosis, are reviewed. Careful angiographic observation will verify closure of the fistula. Aggravation of visual and/or ocular symptoms can also develop with spontaneous carotid-cavernous fistulae. Recurrence of symptoms and development of collaterals were noted, especially after carotid ligation or embolization of the external carotid artery. Electrothrombosis successfully closed the fistulae in 7 patients. The internal carotid artery was occluded in 1 patient who had a preoperative carotid stenosis at the cervical level. The ability to differentiate angiographically between single and multiple fistulae provides a new possibility that spontaneous carotid-cavernous fistulae can be treated with detachable balloon catheters.
D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000601:surgery*; D002342:Carotid Artery, External / Q000601:surgery; D002343:Carotid Artery, Internal / Q000601:surgery; D002426:Cavernous Sinus / Q000601:surgery*; D002533:Cerebral Angiography; D004388:Dura Mater / Q000098:blood supply; D004564:Electrocoagulation; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged