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Spontaneous Carotid-Cavernous Sinus Fistula; Analysis of 16 cases Takashi ANDOH 1 , Toshihiko NAKASHIMA 1 , Yuhzou ARAKI 1 , Noboru SAKAI 1 , Hiromu YAMADA 1 , Yasuo KAGAWA 2 , Toshifumi HIRATA 3 , Yuhsuke TANABE 4 , Mitsuaki TAKADA 5 1Department of Neurosurgery, Gifu University, School of Medicine 2Department of Neurosurgery, Ehime Rosai Hospital 3Department of Neurosurgery, Matsunami General Hospital 4Department of Neurosurgery, Gifu City Hospital 5Department of Neurosurgery, Takayama Red Cross Hospital Keyword: Spontaneous carotid-cavernous sinus fistula , Spontaneous regression , Embolization , Irradiation pp.831-839
Published Date 1991/9/10
DOI https://doi.org/10.11477/mf.1436900318
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Abstract

We have encountered 16 cases with spontaneous carotid-cavernous sinus fistula. According to the classi-fication reported by Barrow, one case was type A ; direct shunt between the internal carotid artery (ICA) and the cavernous sinus (CS) , 5 were type B ; dural shunt between meningeal branches of the ICA and the CS, 6 were type C ; dural shunt between meningeal branches of the external carotid artery (ECA) and the CS, and 4 were type D ; dural shunt between menin-geal branches of both ICA and ECA and CA. Of all cases, 8 patients with low-flow fistula treated conserva-tively improved spontaneously. Three patients were treat-ed with irradiation. Consequently, good results were obtained in 2 cases, but no improvement could be obtained in the remaining one with high flow fistula. Another four patients were treated with intravascular embolization via the ECA, and their symptoms im-proved. But one patient treated with Ivalon emboliza-tion died because of complicated pulmonary embolism. As spontaneous CCF had a high rate of spontaneous regression of symptoms, conservative treatment such as Matas manuever or irradiation should be recommended at first for low flow cases in type B, C, and D. Surgical therapy such as intravascular embolization should be carried out for high-flow cases in type C and D.


Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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