Persistent primitive trigeminal artery-cavernous sinus fistula with intracerebral hemorrhage: endovascular treatment using detachable coils in a transarterial double-catheter technique. Case report and review of the literature.
Intracerebral hemorrhage occurred in this 61-year-old woman with preexisting diplopia and proptosis. Results of angiography demonstrated a persistent primitive trigeminal artery (PPTA)-cavernous sinus fistula with cortical venous reflux. Two microcatheters were introduced transarterially through the PPTA into the two draining pathways in the cavernous sinus. Coils were delivered in both pathways simultaneously to prevent further venous overload on either path. The fistula was successfully occluded without complication while the PPTA was preserved. The authors describe this double-catheter technique for coil embolization of a fistula and review the literature concerning PPTA-cavernous sinus fistulas.
Department of Neurological Surgery, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan. kojitoku@md.okayama-u.ac.jp
Koji
K
Tokunaga
Kenji
K
Sugiu
Masahiro
M
Kameda
Kyoji
K
Sakai
Kaoru
K
Terasaka
Toru
T
Higashi
Isao
I
Date
D002404:Catheterization; D002426:Cavernous Sinus / Q000473:pathology*; D002536:Cerebral Arteries / Q000002:abnormalities* / Q000473:pathology*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005402:Fistula / Q000473:pathology / Q000628:therapy*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology* / Q000628:therapy*; D008875:Middle Aged