Search tips
Search criteria 


Logo of skullbasesurgInstructions for AuthorsSubscribe to Skull BaseAbout Skull BaseEditorial BoardThieme Medical PublishingSkull Base An Interdisciplinary Approach ...
Skull base surgery. 1994 April; 4(2): 103–109.
PMCID: PMC1656484

Combined Arterial and Venous Approaches for Cure of Carotid-Cavernous Sinus Fistula in a Patient with Fibromuscular Dysplasia


We report the case of a woman with bilateral carotid artery fibromuscular dysplasia. The case illustrates some of the difficulties encountered in the treatment of carotid-cavernous fistula. For example, a previous contralateral carotid closure caused complications because carotid sacrifice was not now possible. This resulted in several embolization procedures requiring prolonged x-ray exposures. We show that transvascular embolotherapy must incorporate a flexible approach for access, selection of embolic materials, and clinical care.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.3M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Hieshima GB, Cahan LD, Mehringer CM, Bentson JR. Spontaneous arteriovenous fistulas of cerebral vessels in association with fibromuscular dysplasia. Neurosurgery. 1986 Apr;18(4):454–458. [PubMed]
  • Zimmerman R, Leeds NE, Naidich TP. Carotid-cavernous fistula associated with intracranial fibromuscular dysplasia. Radiology. 1977 Mar;122(3):725–726. [PubMed]
  • Bellot J, Gherardi R, Poirier J, Lacour P, Debrun G, Barbizet J. Fibromuscular dysplasia of cervico-cephalic arteries with multiple dissections and a carotid-cavernous fistula. A pathological study. Stroke. 1985 Mar-Apr;16(2):255–261. [PubMed]
  • Dardenne G. Letter: Treatment of bilateral carotid-cavernous fistulas. J Neurosurg. 1976 Feb;44(2):268–269. [PubMed]
  • Laws ER, Jr, Onofrio BM, Pearson BW, McDonald TJ, Dirrenberger RA. Successful management of bilateral carotid-cavernous fistulae with a trans-sphenoidal approach. Neurosurgery. 1979 Feb;4(2):162–167. [PubMed]
  • Numaguchi Y, Higashida RT, Abernathy JM, Pisarello JC. Balloon embolization in a carotid-cavernous fistula in fibromuscular dysplasia. AJNR Am J Neuroradiol. 1987 Mar-Apr;8(2):380–382. [PubMed]
  • Kendall B. Results of treatment of arteriovenous fistulae with the Debrun technique. AJNR Am J Neuroradiol. 1983 May-Jun;4(3):405–408. [PubMed]
  • Kerber CW, Bank WO, Cromwell LD. Cyanoacrylate occlusion of carotid-cavernous fistula with preservation of carotid artery flow. Neurosurgery. 1979 Mar;4(3):210–215. [PubMed]
  • Samson D, Ditmore QM, Beyer CW., Jr Intravascular use of isobutyl 2-cyanoacrylate: Part 2 Treatment of carotid-cavernous fistulas. Neurosurgery. 1981 Jan;8(1):52–55. [PubMed]
  • Cagnon CH, Benedict SH, Mankovich NJ, Bushberg JT, Seibert JA, Whiting JS. Exposure rates in high-level-control fluoroscopy for image enhancement. Radiology. 1991 Mar;178(3):643–646. [PubMed]
  • Isamat F, Ferrer E, Twose J. Direct intracavernous obliteration of high-flow carotid-cavernous fistulas. J Neurosurg. 1986 Dec;65(6):770–775. [PubMed]
  • Mullan S. Treatment of carotid-cavernous fistulas by cavernous sinus occlusion. J Neurosurg. 1979 Feb;50(2):131–144. [PubMed]
  • Scialfa G, Vaghi A, Valsecchi F, Bernardi L, Tonon C. Neuroradiological treatment of carotid and vertebral fistulas and intracavernous aneurysms. Technical problems and results. Neuroradiology. 1982;24(1):13–25. [PubMed]
  • Barrow DL, Fleischer AS, Hoffman JC. Complications of detachable balloon catheter technique in the treatment of traumatic intracranial arteriovenous fistulas. J Neurosurg. 1982 Mar;56(3):396–403. [PubMed]
  • King WA, Hieshima GB, Martin NA. Venous rupture during transvenous approach to a carotid-cavernous fistula. Case report. J Neurosurg. 1989 Jul;71(1):133–137. [PubMed]
  • Guglielmi G, Viñuela F, Briganti F, Duckwiler G. Carotid-cavernous fistula caused by a ruptured intracavernous aneurysm: endovascular treatment by electrothrombosis with detachable coils. Neurosurgery. 1992 Sep;31(3):591–597. [PubMed]

Articles from Skull Base Surgery are provided here courtesy of Thieme Medical Publishers