RT Journal Article
SR Electronic
T1 Multiple Unilateral Traumatic Carotid-Cavernous Sphenoid Sinus Fistulas with Associated Massive Epistaxis: A Consequence of Parkour
JF Ochsner Journal
JO Ochsner J
FD O. P. Jindal Global University
SP 92
OP 96
VO 15
IS 1
A1 Jason F. Harrison
A1 Rafael A. Vega
A1 Theofilos G. Machinis
A1 John F. Reavey-Cantwell
YR 2015
UL http://www.ochsnerjournal.org/content/15/1/92.abstract
AB Background Traumatic carotid-cavernous fistulas (CCFs) present the clinician with diagnostic and surgical challenges. Extension of a CCF into the sphenoid sinus presents additional management difficulties. Endovascular interventions using various thrombogenic materials such as balloons, coils, or liquids are effective treatment strategies. Ideally, these techniques are used to obliterate the fistula while maintaining the patency of the parent artery.Case Report We present a rare case of traumatic carotid-cavernous sphenoid sinus fistulas complicated by multiple tears in the internal carotid artery with direct communication to the cavernous and sphenoid sinus. As a result, the patient developed massive epistaxis requiring emergent endovascular intervention. A total of 87 detachable coils were placed into the cavernous and sphenoid sinuses via transarterial and transvenous routes in a staged procedure, resulting in complete obliteration of the patient's multiple fistulas.Conclusion To our knowledge, this is the first reported case of multiple fistulous tears in the internal carotid artery with extension to the cavernous and sphenoid sinus. This report emphasizes the importance of early diagnosis and neurosurgical intervention.