[An unusual combination of carotid artery-cavernous sinus fistula and sinus thrombosis. Successful therapy with anticoagulation].
Dural carotid cavernous fistulas (DCCF) can be associated with venous thrombosis. We report on a rare case of a patient who developed a venous infarct, which was diagnosed on CT and MRI. The DCCF predominantly drained through a frontobasal cortical vein into the superior sagittal sinus. The shunt volume was small and was therefore thought not to be sufficient to explain the massive ocular signs, such as severe exophthalmus and reduction of visual acuity. We therefore postulated a venous congestion owing to a secondary spontaneous venous thrombosis of the draining venous pathways to be responsible for the ocular signs. Under anticoagulative medication, the patient's signs and symptoms improved gradually. Control angiography after 3 months showed that the DCCF had disappeared. In the presence of DCCF, anticoagulation should always be considered when a venous thrombosis is suspected.
Yousry
T A
TA
Neuroradiologische Abteilung, Klinikum Grosshadern, München.
Kühne
I
I
Straube
A
A
Brückmann
H
H
D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000188:drug therapy*; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000188:drug therapy*; D002343:Carotid Artery, Internal / Q000473:pathology; D002426:Cavernous Sinus / Q000473:pathology; D002544:Cerebral Infarction / Q000175:diagnosis / Q000188:drug therapy; D003952:Diagnostic Imaging; D004388:Dura Mater / Q000098:blood supply*; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D012851:Sinus Thrombosis, Intracranial / Q000188:drug therapy*
D006493:Heparin