[Risks and therapy options in dural arteriovenous fistulas between branches of the external carotid artery and the cavernous sinus. A case report and review of the literature].
BACKGROUND
Dural arteriovenous fistula of the Arteria carotis externa and the sinus cavernosus are rare vascular malformations. In the literature the prognosis and necessity of treatment is described very variable.


METHODS
A 90 year old female presents in our outpatient clinic with acute exophthalmus, dilated episcleral veins, cerebral bruits and beginning orbital apex syndrome. After normal computerized axial tomography (CAT) without and with contrast medium, we were able to diagnose a dural AV-fistula by angiography. Shortly after dismission the patient had a spontaneous subarachnoidal haemorrhage with severe neurological symptoms.


CONCLUSIONS
The suspect of an intracranial AV-malformation implies a detailed diagnostic search with precise localisation of the process. In any patient with intracerebral and intracranial fistula there has to be an individual check of possible and necessary treatment. It is impossible to classify dural AV-fistula as a benign disease with harmless clinical course.
Thumann
G
G
Abt. für Glaskörper- und Netzhautchirugie, Universitts-Augenklinik Köln.
Baum
U E
UE
Bartz-Schmidt
K U
KU
Lanfermann
H
H
Landwehr
P
P
Esser
P
P
Konen
W
W
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000628:therapy; D002342:Carotid Artery, External / Q000000981:diagnostic imaging*; D002426:Cavernous Sinus / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography; D004388:Dura Mater / Q000098:blood supply*; D005260:Female; D006801:Humans; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy; D014057:Tomography, X-Ray Computed
Risiken und Therapieoptionen bei duralen AV-Fisteln zwischen Asten der Arteria carotis externa und dem Sinus cavernosus. Eine Falldarstellung und Review der Literatur.