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We treated 12 cases of carotid cavernous sinus fistula (CCF) by copper wire insertion into the cavernous sinus through a frontotemporal craniotomy. Five or six copper wires (0.5mm thick and 10mm long) were inserted into the Parkinson's Triangle through a 19 gauge spinal tap needle used as a guide needle under microscopical control. The closure of the fistula was verified in 11 cases by postoperative angiography. In one case, the CCF was partially closed. Postoperative intracerebral hematoma in one case and insertion of the wire into the pons in one case were observed. The third or sixth cranial nerve palsy temporarily worsened in 5 cases. But all patients showed full recovery from these complications. The surgical results in these 12 cases suggest that intracavernous thrombosis by copper wire insertion may prove to be the treatment of choice in CCF.

Treatment of Carotid Cavernous Sinus Fistula by Electrothrombosis using Wire Insertion