Dural carotid cavernous sinus fistula presenting as isolated oculomotor nerve palsy.
We report five patients with dural carotid cavernous sinus fistula presenting with isolated oculomotor nerve palsy. All patients were older women with a fistula derived from the internal carotid artery, who had early filling of the supero-posterior cavernous sinus, followed by drainage posteriorly into the inferior petrosal sinus, with low shunt flow. The hypothesized pathogenesis was nerve compression by an expanding sinus, or ischemic neuropathy secondary to venous congestion or arterial steal. Dural carotid cavernous sinus fistula must be considered in patients presenting with isolated oculomotor nerve palsy.
Miyachi
S
S
Department of Neurosurgery, Nagoya University School of Medicine, Japan.
Negoro
M
M
Handa
T
T
Sugita
K
K
D000368:Aged; D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000150:complications / Q000175:diagnosis*; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis*; D002343:Carotid Artery, Internal; D002426:Cavernous Sinus; D003937:Diagnosis, Differential; D004388:Dura Mater; D005260:Female; D006801:Humans; D015840:Oculomotor Nerve Diseases / Q000209:etiology*