Recurrent Carotid Cavernous Fistula Originating from a Giant Cerebral Aneurysm after Placement of a Covered Stent.
Jung Wook BaekHae Woong JeongYoung Seo LeeYoung-Gyun JeongHae Woong JeongJin Wook BaekJung Hwa SeoPublished in: Journal of cerebrovascular and endovascular neurosurgery (2016)
We report the case of a recurrent carotid cavernous fistula (CCF) originating from a giant cerebral aneurysm (GCA) after placement of a covered stent. A 47-year-old woman presented with sudden onset of severe headache, and left-sided exophthalmos and ptosis. Cerebral angiography revealed a CCF caused by rupture of a GCA in the cavernous segment of the left internal carotid artery. Two covered stents were placed at the neck of the aneurysm. The neurological symptoms improved at first, but were aggravated in the 6 months following the treatment. Contrast agent endoleak was seen in the distal area of the stent. Even though additional treatments were attempted via an endovascular approach, the CCF could not be cured. However, after trapping the aneurysm using coils and performing superficial temporal artery-middle cerebral artery bypass, the neurological symptoms improved. In cases of recurrent CCF originating from a GCA after placement of a covered stent, it is possible to treat the CCF by endovascular trapping and surgical bypass.
Keyphrases
- middle cerebral artery
- internal carotid artery
- coronary artery
- abdominal aortic aneurysm
- subarachnoid hemorrhage
- cerebral ischemia
- ultrasound guided
- computed tomography
- magnetic resonance
- sleep quality
- magnetic resonance imaging
- early onset
- single cell
- blood brain barrier
- cerebral blood flow
- combination therapy
- physical activity
- contrast enhanced
- replacement therapy