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Traumatic posterior communicating artery-cavernous fistula, angioarchitecture, and possible pathogenesis: a case report and literature review

Authors Du B, Zhang M, Liu Q, Shen J, Wang Y

Received 17 September 2015

Accepted for publication 2 December 2015

Published 30 March 2016 Volume 2016:12 Pages 707—711

DOI https://doi.org/10.2147/NDT.S96588

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 3

Editor who approved publication: Professor Wai Kwong Tang


Bin Du,1,* Meng Zhang,2,* Qing-Lin Liu,2 Jie Shen,2 Yun-Yan Wang2

1Department of Neurosurgery, Jinan Central Hospital Affiliated to Shandong University, 2Department of Neurosurgery, Qi Lu Hospital, Shandong University, Jinan, People’s Republic of China

*These authors contributed equally to this work

Abstract: Carotid-cavernous fistulas (CCFs) are an abnormal vascular shunt between the carotid artery and the cavernous sinus, and were traditionally classified into four subtypes based on the detailed fistulas anatomy and arterial supply. CCFs are frequently encountered in patients with traumatic skull base fractures. In this report, we present one such case caused by two head traumas. Computed tomography and digital subtraction angiography confirmed that this CCF arose from posterior communicating artery of the internal carotid artery, which is not included in the traditional Barrow et al’s categorization. The possible mechanisms include laceration of dural mater of posterior clinoid process and laceration or pseudoaneurysm formation of posterior communicating artery. This case was successfully treated with endovascular coil embolization.

Keywords: carotid-cavernous fistulas, cavernous sinus, CCF, PComA, posterior communicating artery

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