| Direct Carotid Cavernous Fistula of an Adult-Type Persistent Primitive Trigeminal Artery with Multiple Vascular Variations. |
| Sung Chul Jin, Hyun Park, Do Hoon Kwon, Choong Gon Choi |
1Cerebrovascular Center, Inje University, Haeundae Paik Hospital, Busan, Korea.
2Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
3Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. ykwon@amc.seoul.kr
4Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. |
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| ABSTRACT |
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We report a case of spontaneous right carotid-cavernous fistula (CCF) in a proximal segment of persistent primitive trigeminal artery (PPTA) and combined vascular anomalies such as left duplicated hypoplastic proximal posterior cerebral arteries and a variation of anterior choroidal artery supplying temporal and occipital lobe. A 45-year-old male presented with progressive right exophthalmos, diplopia, and ocular pain. With manual compression of the internal carotid artery, a cerebral angiography revealed a right CCF from a PPTA. Treatment involved the placement of detachable non-fibered and fibered coils, and use of a hyperglide balloon to protect against coil herniation into the internal carotid artery. A final angiograph revealed complete occlusion of PPTA resulted in no contrast filling of CCF. |
| Key Words:
Persistent primitive trigeminal artery; Carotid cavernous fistula; Duplicated posterior cerebral artery |
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