Table 1 Clinical, angiographic characteristics and treatment outcome of 24 patients with carotid cavernous fistula
No | Age, gender, side | Symptom onset | Clinical manifestation | Etiology | Barrow classification | Feeder artery | Draining vein | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|
Direct (type A) CCF | |||||||||
1 | 24, M, S | 4 y | Proptosis, ophthalmoplegia, visual loss, headache | Trauma | Type A | ICA | SOV, SMCV, IPS, SPS | Coil, surgical ligation | IO |
2 | 35, F, D | 3 mo | Proptosis, chemosis, visual loss, ophthalmoplegia | Trauma | Type A | ICA | SOV, SMCV, IPS | Coil + surgical ligation | CO |
3 | 20, M, S | 2 mo | Bilateral proptosis, chemosis, ophthalmoplegia | Trauma | Type A | ICA | SOV, IOV, BVR, IC, SPS, IPS, CP | Coil | IO |
4 | 13, M, D | 5 mo | Ophthalmoplegia, proptosis. headache | Trauma | Type A | ICA | SOV, BVR, SPS, IPS | Coil | CO |
5 | 55, M, S | 1 mo | Proptosis, chemosis headache | Trauma | Type A | ICA | SOV | Coil | CO |
6 | 12, F, D | 1 mo | Ophthalmoplegia, proptosis, chemosis, visual loss, conjunctival injection | Trauma | Type A | ICA | SOV, IOV | Coil | CO |
7 | 42, M, D | 4 mo | Proptosis, chemosis, Ophthalmoplegia | Trauma | Type A | ICA | SOV, IOV, IPS, SPS, PP | Coil (Terminated due to difficult navigation) | IO |
8 | 38, M, S | 5 mo | Headache, Proptosis, Epistaxis, visual loss | Trauma | Type A | ICA | SOV, PP | Balloon + coil | CO |
9 | 25, M, S | 5 mo | Proptosis, ophthalmoplegia, headache, conjunctival injection | Trauma | Type A | ICA | SOV | Balloon | CO |
10 | 38, M, S | 3 d | Headache, conjunctival injection, proptosis, chemosis, visual loss, right hemiparesis | Trauma | Type A | ICA | SOV, IPS, SMCV | Balloon | IO |
11 | 17, M, D | 2 mo | Proptosis, visual loss, chemosis, ophthalmoplegia, left hemiparesis | Trauma | Type A | ICA | SOV, SMCV, BVR, SPS, IPS | Coil | CO |
12 | 17, M, S | 12 y | Proptosis, chemosis, headache | Trauma | Type A | ICA | SOV, IOV, IPS, SMCV | Coil | CO |
13 | 38, M, D | 3 w | Chemosis, headache, bilateral tinnitus | Trauma | Type A | ICA | SOV, IPS, PP, CP, IC | Coil (parent artery sacrifice) | CO |
14 | 21, M, D | 3 w | Proptosis, headache, ophthalmoplegia, chemosis | Trauma | Type A | ICA | SOV | Coil + surgical ligation | CO |
15 | 54, M, S | 4 mo | Ophthalmoplegia, proptosis, conjunctival injection, tinnitus | Trauma | Type A | ICA | SOV, IPS, CP | Coil | CO |
16 | 24, M, S | 1 mo | Bilateral proptosis, chemosis, visual loss | Trauma | Type A | ICA | SOV, IPS, IC | Coil | CO |
17 | 15, M, S | 3 mo | Headache, proptosis, chemosis, ophthalmoplegia, conjunctival injection, visual loss | Trauma | Type A | ICA | SOV, SMCV | Coil (Parent artery sacrifice) | CO |
Indirect (type B, C, D) CCF | |||||||||
18 | 22, F, B | 2 mo | Bilateral ophthalmoplegia, Headache | Spontaneous | D: Type D; S: Type D | D: MHT, IMA, FR S: MHT | D: SOV, IPS S:SOV, IPS | D: EVOH S: coil | IO |
19 | 56, F, D | 1 mo | Headache, proptosis, chemosis, visual loss, conjunctival injection | Trauma (presumably, based on history, and lack of signs indicating other causes) | Type B | MHT | SOV, IC | Conservative | CO |
20 | 60, M, D | 2 mo | Proptosis, conjunctival injection, visual loss | Spontaneous | Type D | MHT, IMA | SOV | Conservative | IO |
21 | 46, F, D | 6 mo | Proptosis, headache, visual loss | Spontaneous | Type D | MHT, MMA | SOV | Conservative | IO |
22 | 56, M, S | 2 mo | Headache, proptosis, chemosis | Spontaneous | Type B | MHT | SOV, IOV, IC | Conservative | CO |
23 | 8, M, D | 7 mo | Proptosis, visual loss | Spontaneous | Type C | IMA, FR | SOV | EVOH | IO |