ArticleJournal of neurosurgery. Case lessons2025
Transcirculation repair of a direct carotid-cavernous fistula in a patient who presented with hydrocephalus: illustrative case.
Article in Journal of neurosurgery. Case lessons, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDirect carotid-cavernous fistulas (CCFs) are relatively rare but dangerous complications of penetrating traumatic brain injury or maxillofacial trauma. A variety of clinical signs have been described, including ophthalmological and neurological ones. In some cases, severely altered cerebral blood flow can present as massive life-threatening bleeding through the nose, subarachnoid hemorrhage, and/or intraparenchymal hemorrhage. Although intuitively it makes sense that the elevation of venous pressure can obstruct the absorption of cerebrospinal fluid after the formation of a CCF, reports of CCFs presenting with acute acquired hydrocephalus do not exist. OBSERVATIONS: This case illustrates the development of hydrocephalus in a patient with a direct CCF. LESSONS: In the absence of a direct path of access to the cavernous sinus due to occlusion of the carotid artery and difficult venous access, a transcirculation route was used to obliterate the CCF and resolve the hydrocephalus in this patient. https://thejns.org/doi/10.3171/CASE24618.
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