Carotid cavernous fistula
Issued Date
2024-01-01
Resource Type
Scopus ID
2-s2.0-85202806294
Journal Title
Neurological and Neurosurgical Emergencies
Start Page
319
End Page
331
Rights Holder(s)
SCOPUS
Bibliographic Citation
Neurological and Neurosurgical Emergencies (2024) , 319-331
Suggested Citation
Yuyen T. Carotid cavernous fistula. Neurological and Neurosurgical Emergencies (2024) , 319-331. 331. doi:10.1016/B978-0-443-19132-9.00019-4 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/101120
Title
Carotid cavernous fistula
Author(s)
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
A carotid-cavernous sinus fistula is an abnormal communication between arteries and veins within the cavernous sinus. It is generally categorized into high-flow, direct CCF and low-flow, indirect CCF. CCF formation is caused by either trauma or spontaneously. CCF affects the structures within the cavernous sinus, including the internal carotid artery (ICA), abducens nerve (CN VI), oculomotor nerve (CN III), trochlear nerve (CN IV), ophthalmic branch of the trigeminal nerve (CN V1), and maxillary branch of the trigeminal nerve (CN V2). Accordingly, the clinical presentations of CCF may involve ophthalmologic or neurologic systems. The radiographic investigations include noninvasive imaging modalities such as CT scanning, MRI, CT/MR angiography, and invasive cerebral angiography, the gold standard for CCF diagnosis. The goal of treatment is to completely occlude the fistula while maintaining normal blood flow through the ICA. Treatment options for CCF closure include external compression of the ICA, endovascular interventions, radiosurgical interventions, and surgical interventions. Endovascular intervention has become the treatment of choice for most CCFs. It provided favorable outcomes with low rates of recurrence, morbidity, and mortality.