title: Posterior fossa dural arteriovenous fistula presenting clinically as a carotid-cavernous fistula treated by a direct access cavernous sinus approach.
abstract: Dural arteriovenous fistulas (dAVFs) represent approximately 10-15% of all cerebral vascular malformations. Although dAVFs can occur anywhere in the brain, they occur most frequently in the cavernous and transverse-sigmoid sinuses. Posterior fossa dAVFs presenting clinically as carotid-cavernous fistulae (CCF) are rarely encountered in clinical practice. We discuss and illustrate an unusual case of a left posterior fossa dAVF that presented clinically with chemosis and early visual impairment, similar to that of CCF. This was subsequently treated by a direct access cavernous sinus approach. We describe the technique used to access the cavernous sinus directly in cases where conventional transvenous and transarterial routes have been exhausted.
authors: Department of Neuroradiology, National Neuroscience Institute, Singapore.
authors: Ai Peng
authors: AP
authors: Tan
authors: Manish
authors: M
authors: Taneja
authors: Francis
authors: F
authors: Hui
mesh_terms: D020216:Carotid-Cavernous Sinus Fistula / Q000209:etiology* / Q000628:therapy; D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000628:therapy; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic / Q000379:methods; D057510:Endovascular Procedures / Q000379:methods; D006801:Humans; D018810:Magnetic Resonance Angiography; D014786:Vision Disorders / Q000209:etiology
keywords: Fistula; Posterior fossa; Technique; Vascular Malformation