What is a dural carotid cavernous fistula?
Dural carotid–cavernous fistulas (DCCFs) constitute a rare condition caused by abnormal communications between meningeal branches of the internal or external carotid artery and the cavernous sinus, typically diagnosed in postmenopausal women.
What is a dural sinus fistula?
Dural arteriovenous fistulas (dAVFs) are abnormal connections between an artery and a vein in the tough covering over the brain or spinal cord (dura mater). In this rare condition, abnormal passageways between arteries and veins (arteriovenous fistulas) may occur in the brain, spinal cord or other areas of your body.
What causes cavernous sinus fistula?
It is a hole or tear in a branch of your carotid artery inside the cavernous sinus. This tear is called a fistula, and it is usually caused by accident or injury, including: Being hit in the head. Car accident.
What are the connections of the cavernous sinus?
As a venous sinus, the cavernous sinus receives blood from the superior and inferior ophthalmic veins and from superficial cortical veins, and is connected to the basilar plexus of veins posteriorly.
Where is carotid cavernous fistula located?
A carotid-cavernous sinus fistula (CCF) is an abnormal connection between an artery in your neck and the network of veins at the back of your eye. These veins at the back of your eye transport blood from your face and brain back to your heart and are located in small spaces behind your eyes called cavernous sinuses.
What are the main clinical signs of direct carotid cavernous fistula?
The most common findings include arterialization of the conjunctival veins, chemosis, proptosis, diplopia, bruit, retro-orbital headache, elevated intraocular pressure, and a decrease in vision. The classic triad of ocular symptoms seen in direct CCFs are less commonly seen in indirect CCFs.
What 4 structures drain the cavernous sinus?
The cavernous sinus drains to the superior and inferior petrosal sinuses, which then join the sigmoid sinus….The veins that communicate with the cavernous sinus are:
- Superior ophthalmic vein.
- Inferior ophthalmic vein.
- Superficial middle cerebral vein.
- Middle meningeal vein.
- Hypophyseal veins.
What structure passes through cavernous sinus?
The internal carotid artery and the abducens nerve pass through the cavernous sinus.
How common is a carotid cavernous fistula?
Carotid cavernous fistulas (CCFs) are a rare but potentially devastating cause of orbital symptoms, visual loss and periocular disfigurement. CCF patients typically present with proptosis, elevated intraocular pressure, prominent tortuous conjunctival vessels and sometimes headache.
Is DAVF life threatening?
Some DAVFs are life threatening and may cause headaches, seizures or, if they rupture, strokes. Others are benign and go undetected until discovered during treatment for other conditions.
Which nerves run through the cavernous sinus?
The nerves of the cavernous sinus are the oculomotor nerve (CN III), trochlear nerve (CN IV), ophthalmic nerve (V1), maxillary nerve (V2), abducens nerve (CN VI), and the sympathetic plexus around the internal carotid artery.
Is carotid cavernous fistula serious?
Indirect CCFs tend to cause fewer, less serious symptoms. This is because of their relatively low rate of blood flow. Direct CCFs usually require more urgent attention.
How do they fix a brain fistula?
Treatment Options
- Microsurgery is the most appropriate treatment for a dural, brain, or spinal AVF, either alone or in combination with endovascular embolization.
- Stereotactic radiosurgery is appropriate if an AVF is located too close to important brain structures for us to safely perform embolization or microsurgery.