title: Direct carotid cavernous fistula of an adult-type persistent primitive trigeminal artery with multiple vascular variations.
abstract: We report a case of spontaneous right carotid-cavernous fistula (CCF) in a proximal segment of persistent primitive trigeminal artery (PPTA) and combined vascular anomalies such as left duplicated hypoplastic proximal posterior cerebral arteries and a variation of anterior choroidal artery supplying temporal and occipital lobe. A 45-year-old male presented with progressive right exophthalmos, diplopia, and ocular pain. With manual compression of the internal carotid artery, a cerebral angiography revealed a right CCF from a PPTA. Treatment involved the placement of detachable non-fibered and fibered coils, and use of a hyperglide balloon to protect against coil herniation into the internal carotid artery. A final angiograph revealed complete occlusion of PPTA resulted in no contrast filling of CCF.
authors: Cerebrovascular Center, Inje University, Haeundae Paik Hospital, Busan, Korea.
authors: Sung-Chul
authors: SC
authors: Jin
authors: Hyun
authors: H
authors: Park
authors: Do Hoon
authors: DH
authors: Kwon
authors: Choong-Gon
authors: CG
authors: Choi
references: Hong Kong Med J. 2006 Aug;12(4):310-2
references: 16912359
references: J Neurosurg. 2004 Oct;101(4):697-9
references: 15481730
references: AJNR Am J Neuroradiol. 1988 Jul-Aug;9(4):741-7
references: 3135718
references: AJNR Am J Neuroradiol. 1998 Nov-Dec;19(10):1953-4
references: 9874555
references: Neurol Med Chir (Tokyo). 2000 Jan;40(1):61-4
references: 10721257
references: Acta Neurochir (Wien). 2008 Jun;150(6):583-8
references: 18431529
references: Skull Base Surg. 1998;8(4):225-8
references: 17171071
references: Neurosurgery. 1995 Feb;36(2):239-44; discussion 244-5
references: 7731502
references: J Neurosurg. 1984 May;60(5):976-84
references: 6716167
references: J Neuroophthalmol. 2000 Dec;20(4):264-5
references: 11130754
references: Surg Neurol. 2007 Nov;68(5):562-7; discussion 567
references: 17961748
references: Neurosurgery. 1990 Nov;27(5):802-5
references: 2259412