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A Case of a Traumatic Trigeminal‐Cavernous Fistula Occluded by Coil Embolization
Author(s) -
Matosevic Benjamin,
Kiechl Stefan,
Werner Philipp,
Hefel Christoph,
Willeit Johann,
Chemelli Andreas
Publication year - 2011
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2010.00528.x
Subject(s) - medicine , trigeminal artery , cavernous sinus , trigeminal nerve , fistula , carotid cavernous fistula , embolization , occlusion , anastomosis , chemosis , guglielmi detachable coil , surgery , radiology , aneurysm , endovascular treatment
BACKGROUND A trigeminal artery as the most common persisting embryonic carotid‐basilar anastomosis is found in up to .2% of adults. In rare instances, trigeminal‐cavernous fistulas develop either spontaneously or after a trauma.RESULTS We present a 16‐year‐old patient with a traumatic trigeminal‐cavernous fistula (Saltzmann type 2), which was successfully treated by interventional occlusion of the persistent trigeminal artery. After intervention, clinical symptoms (chemosis, right‐temporal bruits, and sixth nerve palsy) resolved.DISCUSSION In this case, fistula occlusion was achieved by coil embolization with only 4 coils placed directly at the rupture point of the trigeminal artery but not into the cavernous sinus. Thus, the cavernous sinus was preserved in function and structure. Special anatomy and interventional peculiarities of this unique case are described in detail.