Spontaneous thrombosis and complete disappearance of traumatic carotid-cavernous fistulas after angiography.
Traumatic carotid-cavernous fistula (TCCF) is a direct shunting fistula due to a tear in the cavernous portion of the internal carotid artery (ICA). Spontaneous thrombosis of the high-flow shunts in TCCFs is extremely rare. Most cases are treated using endovascular embolization to relieve the clinical presentations. We report 2 unusual cases of TCCF with spontaneous closure of fistulas at intervals of 2 and 10 days, respectively, after diagnostic angiograms. The possible mechanisms of spontaneous healing of the fistulas in these patients with minor head injury and small fistulas were presumed to be a transient decrease in fistula blood flow because of irritation of and/or subtle injury to the ICA by contrast media and/or catheter during diagnostic angiogram, with thrombosis formation at the fistula.
Luo
Chao-Bao
CB
Department of Radiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC. cbluo@vghtpe.gov.tw
Teng
Michael Mu-Huo
MM
Chang
Feng-Chi
FC
Chang
Cheng-Yen
CY
D000368:Aged; D000792:Angiography; D020216:Carotid-Cavernous Sinus Fistula / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013927:Thrombosis / Q000503:physiopathology*