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Endovascular Management of Carotid Cavernous Fistulas

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Tutorials in Endovascular Neurosurgery and Interventional Neuroradiology

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Abstract

A carotid cavernous fistula (CCF) consists of an abnormal connection between the cavernous segment of the internal carotid artery (ICA) and the cavernous sinus. The resulting high-flow shunt raises pressure in the drainage pathways of the cavernous sinuses and causes symptoms due to venous hypertension in the orbit, cortical or deep cerebral veins and venous stenosis due to secondary hyperplasia. It is the most frequent location of direct intracranial arteriovenous fistulas and the majority are caused by trauma. Spontaneous fistulas are caused by rupture of an aneurysm of the cavernous ICA or other arterial diseases that weakens the wall. The connection is usually a single hole or less frequently a small number of individual holes. The point of rupture in the arterial wall is often large (1–10 mm) and spontaneous cure is therefore rare. Including this condition in a classification of angiographic patterns in dural arteriovenous malformations of the cavernous sinus region [1] is confusing the two conditions and adds little to their understanding or management.

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Authors and Affiliations

  1. Department of Neuroradiology The John Radcliffe Hospital, University of Oxford, Headley Way, OX3 9DU, Oxford, UK

    Dr. James Vincent Byrne

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  1. Dr. James Vincent Byrne
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Correspondence to James Vincent Byrne .

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Byrne, J.V. (2012). Endovascular Management of Carotid Cavernous Fistulas. In: Tutorials in Endovascular Neurosurgery and Interventional Neuroradiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-19154-1_11

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  • DOI: https://doi.org/10.1007/978-3-642-19154-1_11

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  • Publisher Name: Springer, Berlin, Heidelberg

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  • Online ISBN: 978-3-642-19154-1

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