title: Posttraumatic carotid-cavernous fistulae treated by internal carotid artery trapping and high-flow bypass using a radial artery graft--two case reports.
abstract: Two patients presented with post-traumatic carotid-cavernous sinus fistulae (CCFs) that were successfully treated by high-flow bypass using a radial artery graft after initial unsuccessful attempts at obliteration by intravascular embolization. Case 1 was a 20-year-old man with a CCF detected by magnetic resonance imaging and angiography following an accident. Although the CCF appeared partially occluded by intravascular embolization, serial angiography revealed CCF recurrence. The CCF was trapped by placing a high-flow bypass. Case 2 was a 21-year-old man who presented with bilateral CCFs after sustaining face trauma. The bilateral CCFs were directly treated because of recurrence after balloon occlusion. At present, intravascular surgery is the first treatment choice, but placing a high-flow bypass with trapping of the CCF gained time to treat the CCF and may be useful for treating post-traumatic CCF that cannot be effectively eliminated by intravascular techniques.
authors.affiliation: Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, Inba, Chiba, Japan. mizunari@nms.ac.jp
authors.forename: Takayuki
authors.initials: T
authors.lastname: Mizunari
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Murai
authors.forename: Kyongsong
authors.initials: K
authors.lastname: Kim
authors.forename: Shiro
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kamiyama
authors.forename: Akira
authors.initials: A
authors.lastname: Teramoto
mesh_terms: D020212:Carotid Artery Injuries / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000473:pathology / Q000601:surgery*; D020216:Carotid-Cavernous Sinus Fistula / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D002548:Cerebral Revascularization / Q000379:methods*; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D020768:Middle Cerebral Artery / Q000601:surgery; D017534:Radial Artery / Q000637:transplantation*; D058017:Vascular Grafting / Q000379:methods*; D055815:Young Adult