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Case Report
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| Spontaneous resolution of a trauma induced direct carotid cavernous fistula |
| Zain A Sobani1, Arshad Ali2 |
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1Section of Neurosurgery, Dept. of Surgery, Aga Khan University, Stadium Road, Karachi, Pakistan; Affiliation where work was carried out: Elective Student, Department of Neurosurgery, Jinnah Post Graduate Medical Centre, Karachi, Pakistan.
2Pakar Neurosurgeri, Neurosurgeri Klinik, Hospital Sultanah Aminah, Jalan Abu Bakar, Johor Bahru-80100, Johor-Malaysia; Affiliation where work was carried out: Assistant Professor, Department of Neurosurgery, Jinnah Post Graduate Medical Centre, Karachi, Pakistan. |
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doi:10.5348/ijcri-2011-11-67-CR-5
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Address correspondence to: Arshad Ali Pakar Neurosurgeri, Neurosurgeri Klinik, Hospital Sultanah Aminah Jalan Abu Bakar Johor Bahru-80100 Malaysia. Email: doc4brains@yahoo.com |
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| How to cite this article: |
| Sobani ZA, Ali A. Spontaneous resolution of a trauma induced direct carotid cavernous fistula. International Journal of Case Reports and Images 2011;2(11):18-20. |
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Abstract
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Introduction:
Direct carotid cavernous fistulas (CCF) are abnormal communications between the internal carotid artery and the cavernous sinus usually resulting from high energy trauma to the face and base of skull. The management of direct CCF relies on endovascular procedures repairing the malformation as healing cannot take place in the high flow system.
Case Report: A 16-year-old male presented to our clinic with complaints of a progressively bulging left eye. He had suffered a severe head injury two months back resulting in an extradural hematoma in the left temporoparietal region which was surgically evacuated. Cerebral imaging revealed a fistula between the internal carotid artery (ICA) and cavernous sinus. While awaiting definitive treatment, the patient was advised to compress his left carotid artery manually about 15-20 times a day as per tolerance. After two weeks the patient was prepared for a definitive endovascular procedure; however the CCF had spontaneously thrombosed. Conclusion: Although rare, spontaneous resolution of direct CCF may occur and in such cases there may be a role of conservative management by decreasing the flow through the fistula by carotid massage and temporary occlusion. | |
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Key Words:
Carotid cavernous fistulas; Conservative management.
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Author Contributions:
Zain A Sobani - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Arshad Ali - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission:
The corresponding author is the guarantor of submission. |
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Source of support:
None |
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Conflict of interest:
Authors declare no conflict of interest. |
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Copyright:
© Arshad Ali et. al. 2011; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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