Facial and trigeminal neuropathies in cavernous sinus fistulas.
Three patients with carotid-cavernous fistulas had prominent ipsilateral facial nerve neuropathy. One patient also had ipsilateral third division trigeminal neuropathy, manifesting as painful trismus and lower facial numbness. Rarely reported in carotid-cavernous fistula, these neuropathies may occur when there is substantial drainage of the fistula into a dilated inferior petrosal sinus. Closure of the fistula in two cases resulted in full recovery of the neuropathies within weeks to months. The neuropathies may be caused by ischemia from an unfavorable arteriovenous flow gradient, venous compression, or secondary inflammation.
Jensen
Robert W
RW
Kellogg Eye Center, Department of Ophthalmology 1000 Wall Street, Ann Arbor, MI 48105-1912, USA.
Chuman
Hideki
H
Trobe
Jonathan D
JD
Deveikis
John P
JP
D000328:Adult; D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D020216:Carotid-Cavernous Sinus Fistula / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002533:Cerebral Angiography; D005155:Facial Nerve Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D020433:Trigeminal Nerve Diseases / Q000150:complications / Q000209:etiology*; D014313:Trismus / Q000209:etiology