title: Ehlers-Danlos syndrome type IV and recurrent carotid-cavernous fistula: review of the literature, endovascular approach, technique and difficulties.
abstract: We report the follow-up of a previously published case (Forlodou et al. Neuroradiology 38:595-597, 1996) of carotido-cavernous fistulas (CCFs) in a patient presenting with type IV Ehlers-Danlos syndrome (EDS 4) that were successfully treated twice by an endovascular approach. Initial treatment with a detachable balloon was in 1994 for a right CCF, and, 8 years later, a left CCF was treated by selective transarterial occlusion of the cavernous sinus with coils. Unfortunately, the patient suffered from a spontaneous post-operative intracranial haemorrhage in the left hemisphere and died. Review of the literature, technical considerations for bilateral CCF and complication are discussed.
authors.affiliation: Department of Neuroradiology, Laennec Hospital, University of Nantes, 44093 Nantes, France. hdesal@chu-nantes.fr
authors.forename: H A
authors.initials: HA
authors.lastname: Desal
authors.forename: F
authors.initials: F
authors.lastname: Toulgoat
authors.forename: S
authors.initials: S
authors.lastname: Raoul
authors.forename: B
authors.initials: B
authors.lastname: Guillon
authors.forename: S
authors.initials: S
authors.lastname: Bommard
authors.forename: E
authors.initials: E
authors.lastname: Naudou-Giron
authors.forename: E
authors.initials: E
authors.lastname: Auffray-Calvier
authors.forename: A
authors.initials: A
authors.lastname: de Kersaint-Gilly
mesh_terms: D000328:Adult; D021721:Balloon Occlusion; D020216:Carotid-Cavernous Sinus Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D004535:Ehlers-Danlos Syndrome / Q000150:complications*; D004621:Embolization, Therapeutic; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D019106:Postoperative Hemorrhage / Q000209:etiology*; D011859:Radiography; D012008:Recurrence; D019233:Retreatment